Heteroaryl 11-beta-hydroxysteroid dehydrogenase type I inhibitors

ABSTRACT

Novel compounds are provided which are 11-beta-hydroxysteroid dehydrogenase type I inhibitors. 11-beta-hydroxysteroid dehydrogenase type I inhibitors are useful in treating, preventing, or slowing the progression of diseases requiring 11-beta-hydroxysteroid dehydrogenase type I inhibitor therapy. These novel compounds have the structure: 
 
W-L-Z   (I) 
or stereoisomers or prodrugs or pharmaceutically acceptable salts thereof, wherein W, L and Z are defined herein.

This application claims the benefit of U.S. Provisional Application No. 60/688,993, filed Jun. 9, 2005, incorporated herein by reference in its entirety.

BACKGROUND OF THE INVENTION

The steroid hormone cortisol is a key regulator of many physiological processes. However, an excess of cortisol, as occurs in Cushing's Disease, provokes severe metabolic abnormalities including: type 2 diabetes, cardiovascular disease, obesity, and osteoporosis. Many patients with these diseases, however, do not show significant increases in plasma cortisol levels. In addition to plasma cortisol, individual tissues can regulate their glucocorticoid tone via the in situ conversion of inactive cortisone to the active hormone cortisol. Indeed, the normally high plasma concentration of cortisone provides a ready supply of precursor for conversion to cortisol via the intracellular enzyme 11-beta-hydroxysteroid dehydrogenase type I (11beta-HSD1).

11beta-HSD1 is a member of the short chain dehydrogenase superfamily of enzymes. By catalyzing the conversion of cortisone to cortisol, 11beta-HSD1 controls the intracellular glucocorticoid tone according to its expression and activity levels. In this manner, 11beta-HSD1 can determine the overall metabolic status of the organ. 11beta-HSD1 is expressed at high levels in the liver and at lower levels in many metabolically active tissues including the adipose, the CNS, the pancreas, and the pituitary. Taking the example of the liver, it is predicted that high levels of 11beta-HSD1 activity will stimulate gluconeogenesis and overall glucose output. Conversely, reduction of 11beta-HSD1 activity will downregulate gluconeogenesis resulting in lower plasma glucose levels.

Various studies have been conducted that support this hypothesis. For example, transgenic mice expressing 2× the normal level of 11beta-HSD1 in only the adipose tissue show abdominal obesity, hyperglycemia, and insulin resistance. (H. Masuzaki, J. Paterson, H. Shinyama, N. M. Morton, J. J. Mullins, J. R. Seckl, J. S. Flier, A Transgenic Model of Visceral Obesity and the Metabolic Syndrome, Science 294:2166-2170 (2001). Conversely, when the 11beta-HSD1 gene is ablated by homologous recombination, the resulting mice are resistant to diet induced obesity and the accompanying dysregulation of glucose metabolism (N. M. Morton, J. M. Paterson, H. Masuzki, M. C. Holmes, B. Staels, C. Fievet, B. R. Walker, J. S. Flier, J. J. Mullings, J. R. Seckl, Novel Adipose Tissue-Mediated Resistance to Diet-induced Visceral Obesity in 11β-Hydroxysteroid Dehydrogenase Type 1-Deficient Mice. Diabetes 53: 931-938 (2004). In addition, treatment of genetic mouse models of obesity and diabetes (ob/ob, db/db and KKAy mice) with a specific inhibitor of 11beta-HSD1 causes a decrease in glucose output from the liver and an overall increase in insulin sensitivity (P. Alberts, C. Nilsson, G. Selen, L. O. M. Engblom, N. H. M. Edling, S. Norling, G. Klingstrom, C. Larsson, M. Forsgren, M. Ashkzari, C. E. Nilsson, M. Fiedler, E. Bergqvist, B. Ohman, E. Bjorkstrand, L. B. Abrahmsen, Selective Inhibition of 11β-Hydroxysteroid Dehydrogenase Type I Improves Hepatic Insuling Sensuitivity in Hyperglycemic Mice Strains, Endocrinology 144: 4755-4762 (2003)). Furthermore, inhibitors of 11beta-HSD1 have been shown to be effective in treating metabolic syndrome and atherosclerosis in high fat fed mice (Hermanowoki-Vosetka et. al., J. Eg. Med., 2002, 202(4), 517-527). Based in part on these studies, it is believed that local control of cortisol levels is important in metabolic diseases in these model systems. In addition, the results of these studies also suggest that inhibition of 11beta-HSD1 will be a viable strategy for treating metabolic diseases such as type 2 diabetes, obesity, and the metabolic syndrome.

Lending further support to this idea are the results of a series of preliminary clinical studies. For example, several reports have shown that adipose tissue from obese individuals has elevated levels of 11beta-HSD1 activity. In addition, studies with carbenoxolone, a natural product derived from licorice that inhibits both 11beta-HSD1 and 11beta-HSD2 (converts cortisol to cortisone in kidney) have shown promising results. A seven day, double blind, placebo controlled, cross over study with carbenoxolone in mildly overweight individuals with type 2 diabetes showed that patients treated with the inhibitor, but not the placebo group, displayed a decrease in hepatic glucose production (R. C. Andrews, O. Rooyackers, B. R. Walker, J. Clin. Endocrinol. Metab. 88: 285-291 (2003)). This observation is consistent with the inhibition of 11beta-HSD1 in the liver. The results of these preclinical and early clinical studies strongly support the concept that treatment with a potent and selective inhibitor of 11beta-HSD1 will be an efficacious therapy in patients afflicted with type 2 diabetes, obesity, and the metabolic syndrome.

SUMMARY OF THE INVENTION

In accordance with the present invention, aryl and heteroaryl and related compounds are provided that have the general structure of formula I: W-L-Z   (I) wherein W, L and Z are defined below.

The compounds of the present invention inhibit the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I. Consequently, the compounds of the present invention may be used in the treatment of multiple diseases or disorders associated with 11-beta-hydroxysteroid dehydrogenase type I, such as diabetes and related conditions, microvascular complications associated with diabetes, the macrovascular complications associated with diabetes, cardiovascular diseases, Metabolic Syndrome and its component conditions, inflammatory diseases and other maladies. Examples of diseases or disorders associated with the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I that can be prevented, inhibited, or treated according to the present invention include, but are not limited to, diabetes, hyperglycemia, impaired glucose tolerance, insulin resistance, hyperinsulinemia, retinopathy, neuropathy, nephropathy, delayed wound healing, atherosclerosis and its sequelae (acute coronary syndrome, myocardial infarction, angina pectoris, peripheral vascular disease, intermitant claudication), abnormal heart function, myocardial ischemia, stroke, Metabolic Syndrome, hypertension, obesity, dislipidemia, hyperlipidemia, hypertriglyceridemia, hypercholesterolemia, low HDL, high LDL, non-cardiac ischemia, infection, cancer, vascular restenosis, pancreatitis, neurodegenerative disease, lipid disorders, cognitive impairment and dementia, bone disease, HIV protease associated lipodystrophy, glaucoma and inflammatory diseases, such as, rheumatoid arthritis and osteoarthritis.

Inhibitors of 11beta-HSD1 are also described in U.S. patent application Ser. No. ______, titled “Triazolopyridine 11-Beta Hydroxysteroid Dehydrogenase Type I Inhibitors”, having the same assignee as the present invention and filed concomitantly herewith.

The present invention provides for compounds of formula I, pharmaceutical compositions employing such compounds, and for methods of using such compounds. In particular, the present invention provides a pharmaceutical composition comprising a therapeutically effective amount of a compound of formula I, alone or in combination with a pharmaceutically acceptable carrier.

Further, in accordance with the present invention, a method is provided for preventing, inhibiting, or treating the progression or onset of diseases or disorders associated with the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I, such as defined above and hereinafter, wherein a therapeutically effective amount of a compound of formula I is administered to a mammalian, i.e., human, patient in need of treatment.

The compounds of the invention can be used alone, in combination with other compounds of the present invention, or in combination with one or more other agent(s).

Further, the present invention provides a method for preventing, inhibiting, or treating the diseases as defined above and hereinafter, wherein a therapeutically effective amount of a combination of a compound of formula I and another compound of formula I and/or at least one other type of therapeutic agent, is administered to a mammalian, i.e., human, patient in need of treatment.

DESCRIPTION OF THE INVENTION

In accordance with the present invention, compounds of formula I are provided W-L-Z   (I) enantiomers, diastereomers, solvates, salts or prodrugs thereof wherein:

-   -   W is aryl, cycloalkyl, heteroaryl or heterocyclyl, all of which         may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c)         and R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a),         —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆,         alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or         heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   or alternatively any two R₁, R_(1a), R_(1b), R_(1c) and R_(1d)         can be taken together to form a fused aryl, heteroaryl,         heterocyclyl ring or spiro heterocyclyl ring;     -   L is a bond, O, S, SO, SO₂, alkenyl, cycloalkyl, NR₅, CR₂R_(2a),         CR₂R_(2a)CR_(2b)R_(2c), SO₂NR₂, OCR₂R_(2a),         OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R_(2c)CR₂R_(2a)O,         N(R₅)CR₂R_(2a), CR₂R_(2a)N(R₅), SCR₂R_(2a), CR₂R_(2a)S,         CR₂R_(2a)SO, CR₂R_(2a)SO₂, SOCR₂R_(2a), SO₂CR₂R_(2a),         CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c),         CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a),         CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S,         CR₂R_(2a)CR_(2b)R_(2c)SO, CR₂R_(2a)CR_(2b)R_(2c)SO₂, provided         that L is not a bond when W is phenyl;     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   or alternatively any two R₂, R_(2a), R_(2b), and R_(2c) can be         taken together to which the atom they are attached to form a         cycloalkyl, halogen substituted cycloalkyl or heterocyclyl ring;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a),         —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl,         alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio,         arylsulfonyl, alkylamino, aminoalkyl, arylamino,         heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the         aryl, heteroaryl or heterocyclyl may be optionally substituted         with R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆,         —NR₅SO₂R₆, —COR, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or         heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or         heterocyclyl may be optionally substituted with R₇, R_(7a),         R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —CO₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is alkyl, which may be optionally substituted with one or         more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroayl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with with R₇, R_(7a), R_(7b), and R_(7c);     -   R_(4a) is hydrogen, CN, alkyl, haloalkyl, aryl, substituted         aryl, heteroaryl or substituted heteroaryl;     -   R₅, at each occurrence, is independently hydrogen, alkyl,         cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a),         or SO₂R_(2a);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In another embodiment, compounds of formula I are those in which W is aryl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d).

In another embodiment, compounds of formula I are those in which W is phenyl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d).

In another embodiment, compounds of formula I are those in which Z is selected from the following bicyclic heteroaryl groups:

In another embodiment, compounds of formula I are those in which Z is selected from the following bicyclic heteroaryl groups:

In yet another embodiment, compounds of formula I are those in which L is O.

In another embodiment, compounds of formula I are those in which:

-   -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆,         —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or         heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or         heterocyclyl may be optionally substituted with R₇, R_(7a),         R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1 ]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with with R₇, R_(7a), R_(7b), and R_(7c);     -   R₅, at each occurrence, is independently hydrogen, alkyl,         cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a),         or SO₂R_(2a);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In still yet another embodiment, compounds of formula I are those in which:

-   -   Z is selected from the following bicyclic heteroaryl groups:     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆,         —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or         heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or         heterocyclyl may be optionally substituted with R₇, R_(7a),         R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₅, at each occurrence, is independently hydrogen, alkyl,         cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a),         or SO₂R_(2a);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In one embodiment, compounds of formula I are those in which:

-   -   W is aryl, cycloalkyl or heteroaryl, all of which may be         optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and         R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a),         —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆,         alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or         heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   L is a bond, O, S, SO₂, CR₂R_(2a), SO₂NR₂, OCR₂R_(2a),         OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R_(2c)CR₂R_(2a)O,         SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)SO, CR₂R_(2a)SO₂, SO₂CR₂R_(2a),         CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c),         CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a),         CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S,         CR₂R_(2a)CR_(2b)R_(2c)SO, or CR₂R_(2a)CR_(2b)R_(2c)SO₂;     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a),         —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl,         alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio,         arylsulfonyl, alkylamino, aminoalkyl, arylamino,         heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the         aryl, heteroaryl or heterocyclyl may be optionally substituted         with R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆,         —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or         heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or         heterocyclyl may be optionally substituted with R₇, R_(7a),         R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H,         —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R_(4a) is hydrogen, alkyl, or haloalkyl;     -   R₅, at each occurrence, is independently hydrogen, alkyl,         cycloalkyl, aryl, haloalkyl, COR_(2a)or CO₂R_(2a);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R₇a R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In another embodiment, compounds of formula I are those in which:

-   -   W is aryl, cycloalkyl or heteroaryl, all of which may be         optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and         R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a),         —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), alkyl, haloalkyl,         cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio,         arylsulfonyl, alkylamino, aminoalkyl, arylamino,         heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the         aryl, heteroaryl or heterocyclyl may be optionally substituted         with R₇, R_(7a), R_(7b), and R_(7c);     -   L is a bond, O, S, SO, SO₂, NR₂, CR₂R_(2a),         CR₂R_(2a)CR_(2b)R_(2c), OCR₂R_(2a), CR₂R_(2a)O, SCR₂R_(2a),         CR₂R_(2a)S, CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c),         CR₂R_(2a)SO₂CR_(2b)R_(2c) or SO₂NR₂CR_(2a)R_(2b);     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a),         —SO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or         heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆,         —CO₂R₆, —CO₂H, OCONR₂R_(2a), CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl,         wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);         or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl,         wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In yet another embodiment, compounds of formula I are those in which:

-   -   W is aryl or heteroaryl, both of which may be optionally         substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a),         —SO₂NR₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or         heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O,         SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c);     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), alkyl,         haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio,         arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino,         heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the         aryl, heteroaryl or heterocyclyl may be optionally substituted         with R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆,         —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl,         alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the         alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be         optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR,         —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl,         wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);         or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a),         —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl,         wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In still yet another embodiment, the compounds of formula I are those in which:

-   -   W is aryl or heteroaryl, both of which may be optionally         substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), alkyl, haloalkyl,         cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio,         arylsulfonyl, alkylamino, aminoalkyl, arylamino,         heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the         aryl, heteroaryl or heterocyclyl may be optionally substituted         with R₇, R_(7a), R_(7b), and R_(7c);     -   L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O,         SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c);     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, —CO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy,         aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl,         alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl,         heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or         heterocyclyl may be optionally substituted with R₇, R_(7a),         R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆,         —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino,         heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl,         heteroaryl or heterocyclyl may be optionally substituted with         R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —CN, —CO₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is heterocyclyl, which may be optionally substituted with one         or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —CN, —COR₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In one embodiment, compounds of formula I are those in which:

-   -   W is aryl, which is optionally substituted with R₁, R_(1a),         R_(1b), R_(1c) and R_(1d);

R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);

-   -   L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O,         SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c);     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or         heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆,         —CO₂H, CONR₂R_(2a), SO₂R₆, alkyl, alkoxy, aryl, amino,         heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl,         heteroaryl or heterocyclyl may be optionally substituted with         R₇, R_(7a), R_(7b), and R_(7c); or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —CN, —COR₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy,         aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl,         alkoxy, aryl, heteroaryl or heterocyclyl may be optionally         substituted with R₇, R_(7a), R_(7b), and R_(7c);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl, all of which may be optionally substituted with         with R₇, R_(7a), R_(7b), and R_(7c); and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In another embodiment, compounds of formula I are those in which:

-   -   W is aryl, which is optionally substituted with R₁, R_(1a),         R_(1b), R_(1c) and R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are hydrogen, halogen,         —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, aryl, heteroaryl or heterocyclyl, wherein the aryl,         heteroaryl or heterocyclyl may be optionally substituted with         R₇, R_(7a), R_(7b), and R_(7c);     -   L is a bond, O, S, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O or         CR₂R_(2a)OCR_(2b)R_(2c);     -   R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen,         halogen, alkyl or haloalkyl;     -   Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);

-   -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which         may be optionally substituted with one or more substituents         selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆,         —CO₂H, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl,         wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may         be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c);         or     -   R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or         bicyclo[2,2,1]heptyl, which may be optionally substituted with         one or more substituents selected from halogen, —OH, —OR₆, —SR₆,         —CN, —COR₆, —CO₂R₆, —CO₂H, alkyl, alkoxy, aryl, amino,         heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl,         heteroaryl or heterocyclyl may be optionally substituted with         R₇, R_(7a), R_(7b), and R_(7c);     -   R₄ at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl; and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl,         cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl,         acyl, heteroaryl, heteroaryloxy, heteroarylalkyl,         heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio,         aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂,         —CN or thiol.

In another embodiment, compounds of formula I are those in which:

-   -   W is phenyl, which is optionally substituted with R₁, R_(1a),         R_(1b), R_(1c) and R_(1d);     -   R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently         hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl,         alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl,         alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl;     -   L is O, S, SCH₂, OCH₂, CH₂O or CH₂OCH₂;     -   Z is selected from the following bicyclic heteroaryl groups:     -   R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH,         —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy,         haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino,         aminoalkyl, aryl, heteroaryl or heterocyclyl;     -   R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, all which may         be optionally substituted with one or more substituents selected         from halogen, —OH, —OR₆, —SR₆, —CN, alkyl, alkoxy, aryl, amino,         heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl,         heteroaryl or heterocyclyl may be optionally substituted with         R₇, R_(7a), R_(7b), and R_(7c);     -   R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl         or heteroaryl; and     -   R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are         independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy,         arylalkyl, cycloalkyl, amino, —OH, hydroxyalkyl, heteroaryl,         heteroaryloxy, heteroarylalkyl, alkylthio, arylalkylthio, —NO₂,         or —CN.

In another embodiment, compounds of the present invention are selected from the compounds exemplified in the examples.

In another embodiment, the present invention relates to pharmaceutical compositions comprised of a therapeutically effective amount of a compound of the present invention, alone or, optionally, in combination with a pharmaceutically acceptable carrier and/or one or more other agent(s).

In another embodiment, the present invention relates to methods of inhibiting the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I comprising administering to a mammalian patient, for example, a human patient, in need thereof a therapeutically effective amount of a compound of the present invention, alone, or optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of diseases or disorders associated with the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

Examples of diseases or disorders associated with the activity of the enzyme 11-beta-hydroxysteroid dehydrogenase type I that can be prevented, inhibited, or treated according to the present invention include, but are not limited to, diabetes, hyperglycemia, impaired glucose tolerance, insulin resistance, hyperinsulinemia, retinopathy, neuropathy, nephropathy, delayed wound healing, atherosclerosis, acute coronary syndrome, myocardial infarction, angina pectoris, peripheral vascular disease, intermitant claudication, abnormal heart function, myocardial ischemia, stroke, Metabolic Syndrome, hypertension, obesity, dislipidemia, hyperlipidemia, hypertriglyceridemia, hypercholesterolemia, low HDL, high LDL, non-cardiac ischemia, infection, cancer, vascular restenosis, pancreatitis, neurodegenerative disease, lipid disorders, cognitive impairment and dementia, bone disease, HIV protease associated lipodystrophy, glaucoma, rheumatoid arthritis and osteoarthritis.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of diabetes, hyperglycemia, obesity,dislipidemia, hypertension, cognitive impairment, rheumatoid arthritis, osteoarthritis, glaucoma and Metabolic Syndrome comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In still another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of diabetes, comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In yet still another embodiment, the present invention relates to a method for preventing;. inhibiting, or treating the progression or onset of hyperglycemia comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of obesity comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In one embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of dislipidemia comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of hypertension comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of cognitive impairment comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of rheumatoid arthritis comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of osteoarthritis comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of Metabolic Syndrome comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

In still another embodiment, the present invention relates to a method for preventing, inhibiting, or treating the progression or onset of glaucoma, comprising administering to a mammalian patient, for example, a human patient, in need of prevention, inhibition, or treatment a therapeutically effective amount of a compound of the present invention, alone, or, optionally, in combination with another compound of the present invention and/or at least one other type of therapeutic agent.

Definitions

The compounds herein described may have asymmetric centers. Compounds of the present invention containing an asymmetrically substituted atom may be isolated in optically active or racemic forms. It is well known in the art how to prepare optically active forms, such as by resolution of racemic forms or by synthesis from optically active starting materials. Many geometric isomers of olefins, C═N double bonds, and the like can also be present in the compounds described herein, and all such stable isomers are contemplated in the present invention. Cis and trans geometric isomers of the compounds of the present invention are described and may be isolated as a mixture of isomers or as separated isomeric forms. All chiral, diastereomeric racemic forms, and all geometric isomeric forms of a structure are intended, unless the specific stereochemistry or isomeric form is specifically indicated.

The term “substituted,” as used herein, means that any one or more hydrogens on the designated atom or ring is replaced with a selection from the indicated group, provided that the designated atom's normal valency is not exceeded, and that the substitution results in a stable compound. When a substituent is keto (i.e., ═O), then 2 hydrogens on the atom are replaced.

When any variable (e.g., R^(a)) occurs more than one time in any constituent or formula for a compound, its definition at each occurrence is independent of its definition at every other occurrence. Thus, for example, if a group is shown to be substituted with 0-2 R^(a), then said group may optionally be substituted with up to two R^(a) groups and R^(a) at each occurrence is selected independently from the definition of R^(a). Also, combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.

When a bond to a substituent is shown to cross a bond connecting two atoms in a ring, then such substituent may be bonded to any atom on the ring. When a substituent is listed without indicating the atom via which such substituent is bonded to the rest of the compound of a given formula, then such substituent may be bonded via any atom in such substituent. Combinations of substituents and/or variables are permissible only if such combinations result in stable compounds.

Unless otherwise indicated, the term “lower alkyl,” “alkyl,” or “alk” as employed herein alone or as part of another group includes both straight and branched chain hydrocarbons, containing 1 to 20 carbons, preferably 1 to 10 carbons, more preferably 1 to 8 carbons, in the normal chain, such as methyl, ethyl, propyl, isopropyl, butyl, t-butyl, isobutyl, pentyl, hexyl, isohexyl, heptyl, 4,4-dimethylpentyl, octyl, 2,2,4-trimethyl-pentyl, nonyl, decyl, undecyl, dodecyl, the various branched chain isomers thereof, and the like as well as such groups may optionally include 1 to 4 substituents such as halo, for example F, Br, Cl, or I, or CF₃, alkyl, alkoxy, aryl, aryloxy, aryl(aryl) or diaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, hydroxy, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, nitro, cyan, thiol, haloalkyl, trihaloalkyl, and/or alkylthio.

Unless otherwise indicated, the term “cycloalkyl” as employed herein alone or as part of another group includes saturated or partially unsaturated (containing 1 or 2 double bonds) cyclic hydrocarbon groups containing 1 to 3 rings, including monocyclic alkyl, bicyclic alkyl (or bicycloalkyl) and tricyclic alkyl, containing a total of 3 to 20 carbons forming the ring, preferably 3 to 10 carbons, forming the ring and which may be fused to 1 or 2 aromatic rings as described for aryl, which includes cyclopropyl, cyclobutyl, cyclopentyl, cyclohexyl, cycloheptyl, cyclooctyl, cyclodecyl and cyclododecyl, cyclohexenyl,

any of which groups may be optionally substituted with 1 to 4 substituents such as halogen, alkyl, alkoxy, hydroxy, aryl, aryloxy, arylalkyl, cycloalkyl, alkylamido, alkanoylamino, oxo, acyl, arylcarbonylamino, amino, nitro, cyano, thiol, and/or alkylthio, and/or any of the substituents for alkyl.

Unless otherwise indicated, the term “lower alkenyl” or “alkenyl” as used herein by itself or as part of another group refers to straight or branched chain radicals of 2 to 20 carbons, preferably 2 to 12 carbons, and more preferably 1 to 8 carbons in the normal chain, which include one to six double bonds in the normal chain, such as vinyl, 2-propenyl, 3-butenyl, 2-butenyl, 4-pentenyl, 3-pentenyl, 2-hexenyl, 3-hexenyl, 2-heptenyl, 3-heptenyl, 4-heptenyl, 3-octenyl, 3-nonenyl, 4-decenyl, 3-undecenyl, 4-dodecenyl, 4,8,12-tetradecatrienyl, and the like, and which may be optionally substituted with 1 to 4 substituents, namely, halogen, haloalkyl, alkyl, alkoxy, alkenyl, alkynyl, aryl, arylalkyl, cycloalkyl, amino, hydroxy, heteroaryl, cycloheteroalkyl, alkanoylamino, alkylamido, arylcarbonyl-amino, nitro, cyano, thiol, alkylthio, and/or any of the alkyl substituents set out herein

Unless otherwise indicated, the term “lower alkynyl” or “alkynyl” as used herein by itself or as part of another group refers to straight or branched chain radicals of 2 to 20 carbons, preferably 2 to 12 carbons and more preferably 2 to 8 carbons in the normal chain, which include one triple bond in the normal chain, such as 2-propynyl, 3-butynyl, 2-butynyl, 4-pentynyl, 3-pentynyl, 2-hexynyl, 3-hexynyl, 2-heptynyl, 3-heptynyl, 4-heptynyl, 3-octynyl, 3-nonynyl, 4-decynyl,3-undecynyl, 4-dodecynyl, and the like, and which may be optionally substituted with 1 to 4 substituents, namely, halogen, haloalkyl, alkyl, alkoxy, alkenyl, alkynyl, aryl, arylalkyl, cycloalkyl, amino, heteroaryl, cycloheteroalkyl, hydroxy, alkanoylamino, alkylamido, arylcarbonylamino, nitro, cyano, thiol, and/or alkylthio, and/or any of the alkyl substituents set out herein.

Where alkyl groups as defined above have single bonds for attachment to other groups at two different carbon atoms, they are termed “alkylene” groups and may optionally be substituted as defined above for “alkyl”.

Where alkenyl groups as defined above and alkynyl groups as defined above, respectively, have single bonds for attachment at two different carbon atoms, they are termed “alkenylene groups” and “alkynylene groups”, respectively, and may optionally be substituted as defined above for “alkenyl” and “alkynyl”.

The term “halogen” or “halo” as used herein alone or as part of another group refers to chlorine, bromine, fluorine, and iodine as well as CF₃, with chlorine or fluorine being preferred.

Unless otherwise indicated, the term “aryl” as employed herein alone or as part of another group refers to monocyclic and bicyclic aromatic groups containing 6 to 10 carbons in the ring portion (such as phenyl or naphthyl, including 1-naphthyl and 2-naphthyl) and may optionally include 1 to 3 additional rings fused to a carbocyclic ring or a heterocyclic ring (such as aryl, cycloalkyl, heteroaryl, or cycloheteroalkyl rings for example

and may be optionally substituted through available carbon atoms with 1, 2, or 3 substituents, for example, hydrogen, halo, haloalkyl, alkyl, haloalkyl, alkoxy, haloalkoxy, alkenyl, trifluoromethyl, trifluoromethoxy, alkynyl, cycloalkyl-alkyl, cycloheteroalkyl, cycloheteroalkylalkyl, aryl, heteroaryl, arylalkyl, aryloxy, aryloxyalkyl, arylalkoxy, arylthio, arylazo, heteroarylalkyl, heteroarylalkenyl, heteroarylheteroaryl, heteroaryloxy, hydroxy, nitro, cyano, amino, substituted amino wherein the amino includes 1 or 2 substituents (which are alkyl, aryl, or any of the other aryl compounds mentioned in the definitions), thiol, alkylthio, arylthio, heteroarylthio, arylthioalkyl, alkoxyarylthio, alkylcarbonyl, arylcarbonyl, alkyl-aminocarbonyl, arylaminocarbonyl, alkoxycarbonyl, aminocarbonyl, alkylcarbonyloxy, arylcarbonyloxy, alkylcarbonylamino, arylcarbonylamino, arylsulfinyl, arylsulfinylalkyl, arylsulfonylamino, or arylsulfon-aminocarbonyl, and/or any of the alkyl substituents set out herein.

Unless otherwise indicated, the term “lower alkoxy”, “alkoxy”, “aryloxy” or “aralkoxy” as employed herein alone or as part of another group includes any of the above alkyl, aralkyl, or aryl groups linked to an oxygen atom.

Unless otherwise indicated, the term “amino” as employed herein alone or as part of another group refers to amino that may be substituted with one or two substituents, which may be the same or different, such as alkyl, aryl, arylalkyl, heteroaryl, heteroarylalkyl, cycloheteroalkyl, cycloheteroalkylalkyl, cycloalkyl, cycloalkylalkyl, haloalkyl, hydroxyalkyl, alkoxyalkyl, or thioalkyl. These substituents may be further substituted with a carboxylic acid and/or any of the R¹ groups or substituents for R¹ as set out above. In addition, the amino substituents may be taken together with the nitrogen atom to which they are attached to form 1-pyrrolidinyl, 1-piperidinyl, 1-azepinyl, 4-morpholinyl, 4-thiamorpholinyl, 1-piperazinyl, 4-alkyl-1-piperazinyl, 4-arylalkyl-1-piperazinyl, 4-diarylalkyl-1-piperazinyl, 1-pyrrolidinyl, 1-piperidinyl, or 1-azepinyl, optionally substituted with alkyl, alkoxy, alkylthio, halo, trifluoromethyl, or hydroxy.

Unless otherwise indicated, the term “lower alkylthio,” “alkylthio,” “arylthio,” or “aralkylthio” as employed herein alone or as part of another group includes any of the above alkyl, aralkyl, or aryl groups linked to a sulfur atom.

Unless otherwise indicated, the term “lower alkylamino,” “alkylamino,” “arylamino,” or “arylalkylamino” as employed herein alone or as part of another group includes any of the above alkyl, aryl, or arylalkyl groups linked to a nitrogen atom.

As used herein, the term “heterocyclyl ” or “heterocyclic system” is intended to mean a stable 4- to 12-membered monocyclic or bicyclic heterocyclic ring which is saturated, or partially unsaturated, and which consists of carbon atoms and 1, 2, 3, or 4 heteroatoms independently selected from the group consisting of N, NH, O, and S, and including any bicyclic group in which any of the above-defined heterocyclic rings is fused to a benzene ring. The nitrogen and sulfur heteroatoms may optionally be oxidized. The heterocyclic ring may be attached to its pendant group at any heteroatom or carbon atom which results in a stable structure. The heterocyclic rings described herein may be substituted on carbon or on a nitrogen atom if the resulting compound is stable. If specifically noted, a nitrogen in the heterocycle may optionally be quaternized. It is preferred that when the total number of S and O atoms in the heterocycle exceeds 1, then these heteroatoms are not adjacent to one another.

Unless otherwise indicated, the term “heteroaryl” as used herein alone or as part of another group refers to a 5- or 12-membered aromatic ring, prefereably, a 5- or 6-membered aromatic ring, which includes 1, 2, 3, or 4 hetero atoms such as nitrogen, oxygen, or sulfur, and such rings fused to an aryl, cycloalkyl, heteroaryl, or cycloheteroalkyl ring (e.g. benzothiophenyl, indolyl), and includes possible N-oxides. The heteroaryl group may optionally include 1 to 4 substituents such as any of the substituents set out above for alkyl. Examples of heteroaryl groups include the following:

and the like.

The term “heterocyclylalkyl” or “heterocyclyl” as used herein alone or as part of another group refers to heterocyclyl groups as defined above linked through a C atom or heteroatom to an alkyl chain.

The term “heteroarylalkyl” or “heteroarylalkenyl” as used herein alone or as part of another group refers to a heteroaryl group as defined above linked through a C atom or heteroatom to an alkyl chain, alkylene, or alkenylene as defined above.

The term “cyano” as used herein, refers to a —CN group.

The term “nitro” as used herein, refers to an —NO₂ group.

The term “hydroxy” as used herein, refers to an —OH group.

The phrase “pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.

As used herein, “pharmaceutically acceptable salts” refer to derivatives of the disclosed compounds wherein the parent compound is modified by making acid or base salts thereof. Examples of pharmaceutically acceptable salts include, but are not limited to, mineral or organic acid salts of basic residues such as amines; alkali or organic salts of acidic residues such as carboxylic acids; and the like. The pharmaceutically acceptable salts include the conventional non-toxic salts or the quaternary ammonium salts of the parent compound formed, for example, from non-toxic inorganic or organic acids. For example, such conventional non-toxic salts include those derived from inorganic acids such as hydrochloric, hydrobromic, sulfuric, sulfamic, phosphoric, nitric and the like; and the salts prepared from organic acids such as acetic, propionic, succinic, glycolic, stearic, lactic, malic, tartaric, citric, ascorbic, pamoic, maleic, hydroxymaleic, phenylacetic, glutamic, benzoic, salicylic, sulfanilic, 2-acetoxybenzoic, fumaric, toluenesulfonic, methanesulfonic, ethane disulfonic, oxalic, isethionic, and the like.

The pharmaceutically acceptable salts of the present invention can be synthesized from the parent compound which contains a basic or acidic moiety by conventional chemical methods. Generally, such salts can be prepared by reacting the free acid or base forms of these compounds with a stoichiometric amount of the appropriate base or acid in water or in an organic solvent, or in a mixture of the two; generally, nonaqueous media like ether, ethyl acetate, ethanol, isopropanol, or acetonitrile are preferred. Lists of suitable salts are found in Remington's Pharmaceutical Sciences, 17th ed., Mack Publishing Company, Easton, Pa., 1985, p. 1418, the disclosure of which is hereby incorporated by reference.

Any compound that can be converted in vivo to provide the bioactive agent (i.e., the compound of formula I) is a prodrug within the scope and spirit of the invention.

The term “prodrugs” as employed herein includes phosphates, esters and carbonates formed by reacting one or more hydroxyls of compounds of formula I with alkyl, alkoxy, or aryl substituted acylating or phosphorylating agents employing procedures known to those skilled in the art to generate phosphates, acetates, pivalates, methylcarbonates, benzoates, and the like.

Various forms of prodrugs are well known in the art and are described in:

a) The Practice of a Medicinal Chemistry, Camille G. Wermuth et al., Ch. 31, (Academic Press, 1996);

b) Design of Prodrugs, edited by H. Bundgaard, (Elsevier, 1985);

c) A Textbook of Drug Design and Development, P. Krogsgaard-Larson and H. Bundgaard, eds. Ch. 5, pp. 113-191 (Harwood Academic Publishers, 1991); and

d) Hydrolysis in Drug and Prodrug Metabolism, Bernard Testa and Joachim M. Mayer, (Wiley-VCH, 2003).

Said references are incorporated herein by reference.

In addition, compounds of the formula I are, subsequent to their preparation, preferably isolated and purified to obtain a composition containing an amount by weight equal to or greater than 99% formula I compound (“substantially pure” compound I), which is then used or formulated as described herein. Such “substantially pure” compounds of the formula I are also contemplated herein as part of the present invention.

All stereoisomers of the compounds of the instant invention are contemplated, either in admixture or in pure or substantially pure form. The compounds of the present invention can have asymmetric centers at any of the carbon atoms including any one of the R substituents and/or exhibit polymorphism. Consequently, compounds of formula I can exist in enantiomeric, or diastereomeric forms, or in mixtures thereof. The processes for preparation can utilize racemates, enantiomers, or diastereomers as starting materials. When diastereomeric or enantiomeric products are prepared, they can be separated by conventional methods for example, chromatographic or fractional crystallization.

“Stable compound” and “stable structure” are meant to indicate a compound that is sufficiently robust to survive isolation to a useful degree of purity from a reaction mixture, and formulation into an efficacious therapeutic agent. The present invention is intended to embody stable compounds.

“Therapeutically effective amount” is intended to include an amount of a compound of the present invention alone or an amount of the combination of compounds claimed or an amount of a compound of the present invention in combination with other active ingredients effective to inhibit 11beta-HSD1 or effective to treat or prevent diseases or disorders associated with 11beta-HSD1.

As used herein, “treating” or “treatment” cover the treatment of a disease-state in a mammal, particularly in a human, and include: (a) preventing the disease-state from occurring in a mammal, in particular, when such mammal is predisposed to the disease-state but has not yet been diagnosed as having it; (b) inhibiting the disease-state, i.e., arresting it development; and/or (c) relieving the disease-state, i.e., causing regression of the disease state.

Synthesis

Compounds of formula I of may be prepared as shown in the following reaction schemes and description thereof, as well as relevant literature procedures that may be used by one skilled in the art. Exemplary reagents and procedures for these reactions appear hereinafter and in the working Examples.

Preparing compounds of formula IA (a subset of compounds of formula I). A phenol intermediate II can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. Formation of a compound IA can be carried out from a phenol II and an alcohol III using triphenylphosphine and DEAD or DIAD, commonly known as Mitsunobu Reaction. Alternatively, a compound IA can be obtained from alkylation of a phenol II with a chloride IV or a bromide V in the presence of an appropriate base, such as sodium carbonate or DIEA.

Scheme II describes a method for preparing compounds of formula IB and formula IC (subsets of compounds of formula I). A thiophenol intermediate VI can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. Formation of a compound IB can be obtained from alkylation of a thiophenol VI with a chloride IV or a bromide V in the presence of an appropriate base, such as sodium carbonate or DIEA. Subsequent oxidation of a compound 1B with an appropriate oxidizing reagent such as mCPBA, Oxone®, p-toluenesulfonic peracid generated in situ (Tetrahedron, 1996, 52, 5773-5787) or by other reagents known to one skilled in the art provides a compound 1C.

Scheme III describes a method for preparing compounds of formula ID (a subset of compounds of formula I). An arylsulfonyl chloride intermediate VII can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. Formation of a compound ID can be achieved from the reaction of a compound of formula VII with an amine VIII in the presence of an appropriate base such as pyridine, DIEA or other reagents known to one skilled in the art to provide a compound 1D.

Scheme IV describes a method for preparing compounds of formula IE (a subset of compounds of formula I). A phenol intermediate II can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. Formation of a compound IE can be achieved from treatment of a potassium salt of a phenol II and a bromo- or iodo-substituted intermediate IX (G is Br or I) in the presence of copper powder or salt at elevated temperature, commonly known as Ullmann Coupling Reaction (Tetrahedron, 1984, 40, 1433-1456). Alternatively, a compound IE can be obtained from a S_(N)AR reaction of a phenol II and a bromo-, chloro- or fluoro-substituted intermediate IX (G is Br, Cl or F) in the presence of a base such as potassium hydride, sodium hydride, cesium carbonate, potassium carbonate at elevated temperature. Both Ullmann Coupling and S_(N)AR reactions can be carried out under a conventional procedure or done in a microwave reactor. Furthermore, a compound IE can be obtained from a copper acetate-mediated aryl ether synthesis using a phenol II and an arylboronic acid X or a phenol XII and an arylboronic acid XI (Tetrahedron Lett., 1998, 39, 2937-2940).

Scheme V describes a method for preparing compounds of formula IF (a subset of compounds of formula I where Z is a 1,2,4-triazolopyridine group). A chloro- or fluropyridine intermediate XIII can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate XIII (for example, a TBS group or ether as a protecting group for an alcohol) for better functional group compatibility in the subsequent reaction. Reaction of a compound of formula XIII with hydrazine was carried out at elevated temperature to provide an intermediate XIV. Acylation of an intermediate XIV with an acid XV using an appropriate set of amide coupling reagents such NMM/isobutylchloformate, EDAC/HOBT or other reagents described in “The Practice of Peptide Synthesis” (Spring-Verlag, 2^(nd) Ed., Bodanszy, Miklos, 1993) provides a hydrazide intermediate XVII. Alternatively, a hydrazide XVII can be prepared from the reaction of a compound of formula XIV and an acid chloride XVI in the presence of an appropriate base such as DIEA or TEA. Formation of 1,2,4-triazolopyridine XVIII can be achieved from the reaction of XVII with POCl₃ at an elevated temperature. Formation of 1,2,4-triazolopyridine XVIII can also be achieved from XVII in the presence of acetic acid at an elevated temperature, either under a conventional procedure or a microwave reactor. Alternatively, formation of 1,2,4-triazolopyridine XVIII can be achieved from the reaction of XVII with Ph₃PCl₂ in the presence of a base such as TEA or by other methods known to one skilled in the art. The protecting group, if present, can be removed from a compound of formula XVIII to provide an intermediate XIX (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound of formula 1F can be achieved using reactions described in Schemes I to IV or by other methods known to one skilled in the art.

Scheme VI describes a method for preparing compounds of formula IG (a subset of compounds of formula I where Z is a imidazo[1,2-a]pyridine group). An aminopyridine intermediate XX can be obtained commercially, prepared by methods known in the literature or by other methods known to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate XX (for example, a TBS group or ether as a protecting group for an alcohol) for better functional group compatibility in the subsequent reactions. Reaction of a compound of formula XX with a bromide XXI provides an intermediate XXI, which, upon heating, yields an imidazonvridine intermediate XXIII (Heterocycles, 2003, 59, 359-368). The protecting group, if present, can be removed from a compound of formula XXIII to provide an intermediate XXIV (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1G can be achieved using reactions described in Schemes I to IV, or by other methods known to one skilled in the art.

Scheme VII describes a method for preparing compounds of formula IH (a subset of compounds of formula I where Z is an imidazo[1,5-a]pyridine group). A cyano- or amidopyridine intermediate XXV can be obtained commercially, prepared by methods known in the literature or by other methods Lowry to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate XXV (for example, a TBS group or ether as a protecting group for an alcohol) for better functional group compatibility in the subsequent reaction. Reduction of the cyano or amide moiety in a compound of formula XXV may be carried out using an appropriate reducing reagent such as LAH or other reagents known to one skilled in the art. Acylation of the resulting amine intermediate XXVI can be performed by reacting it with an acid XV in the presence of a set of amide coupling reagents such as NMM/isobutylchloformate, EDAC/HOBT or other reagents described in ”The Practice of Peptide Synthesis” (Spring-Verlag, 2^(nd) Ed., Bodanszy, Miklos, 1993), yielding an amide intermediate XXVII. Alternatively, an amide XXVII can be prepared from the reaction of a compound of formula XXVI and an acid chloride XVI in the presence of an appropriate base such as DIEA or TEA. Formation of imidazolopyridine XXVIII can be achieved from the reaction of XXVII with POCl₃ at an elevated temperature. Alternatively, formation of imidazolopyridine XXVIII can also be achieved from XXVII in the presence of acetic acid at an elevated temperature, either under a conventional procedure or a microwave reactor. Forthermore, formation of imidazolopyridine XXVIII can be achieved from the reaction of XXVII with Ph₃PCl₂ in the presence of a base such as TEA or by other methods known to one skilled in the art. The protecting group, if present, can be removed from compound XXVIII to provide a compound of formula XXIX (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1H can be achieved using reactions described in Schemes I to IV, or by other methods known to one skilled in the art. In cases where R_(4a) is functional group such as cyano or aryl group, the compounds can be prepared via treatment of compound XXVIII to give a bromo intermediate (D. Davey, et al. J. Med. Chem. 1987, 30, 1337-1342) followed by Pd-catalyzed coupling reactions (H. G. Selnick, et al. Syn. Commun. 1995, 25, 3255-3261 and Suzuki, et al. Syn. Commun. 1981, 11, 513-519) to give compound XXVIII_A, or by other methods known to one skilled in the art. The protecting group, if present, can be removed from compound XXVIII_A to provide a compound of formula XXIX_A (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1H can be achieved using reactions described in Schemes I to IV, or by other methods known to one skilled in the art.

Scheme VIII describes a method for preparing compounds of formula IJ (a subset of compounds of formula I where Z is 1,2,3-triazolopyridine group). A bromopyridine intermediate XXX can be obtained commercially, prepared by methods known in the literature, or by other methods known to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate XXX (for example, a TBS group or ether as a protecting group for an alcohol) for better functional group compatibility in the subsequent reaction. Treatment of a compound of formula XXX with n-BuLi followed by addition of a compound XXXI provides a ketone intermediate XXXII. Formation of a 1,2,3-triazolopyridine XXXIII can be achieved by the reaction of a compound XXXII and benzenesulfonohydrazide in the presence of morpholine (Tetrahedron, 1997, 53, 8257-8268), or by other methods known to one skilled in the art. The protecting group, if present, can be removed from compound XXXIII to provide a compound of formula XXXIV (for more protecting group examples and conditions of their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1J can be achieved using reactions described in Schemes I to IV, or by other methods know to one skilled in the art.

Scheme IX describes a method for preparing compounds of formula IK (a subset of compounds of formula I where Z is benzotriazole group). An intermediate XXXV can be obtained commercially, prepared by methods known in the literature, or by other methods known to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate XXXV (for example, a TBS group or ether as a protecting group for an alcohol) for better functional group compatibility in the subsequent reactions. An intermediate XXXVII can be obtained from a nucleophilic aromatic substitution reaction of a compound XXXV with an amine XXXVI at elevated temperature or by palladium-mediated N-arylation (J. Org. Chem., 2000, 65, 1144-1157), or by other methods known to one skilled in the art. Reduction of the nitro group in a compound XXXVII can be carried out with appropriate reducing reagents such as hydrogen in the presence of a Pd—C catalyst or Zn dust in HCl to provide an intermediate XXXVIII. Treatment of a compound XXXVIII with sodium nitrite in the presence of an acid provides a benzotriazole intermediate of formula XXXIX (J. Med. Chem., 1990, 33, 2343-2357). Alternatively, a benzotriazole intermediate XXXIX can be obtained from the reaction of an aniline XXXX and an azide XXXXI in the presence of 3-methyl-1-nitrobutane (J. Chem. Soc. Perkin Trans. 1, 1985, 2733-2739). The protecting group, if present, can be removed from a compound XXXIX to provide a compound of formula XXXXII (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1K can be achieved using reactions described in Schemes I to IV, or by other methods known to one skilled in the art.

Scheme X describes a method for preparing compounds of formula IL (a subset of compounds of formula I where Z is triazolopyridazine group). An intermediate of formula XXXXII can be obtained commercially, prepared by methods known in the literature, or by other methods known to one skilled in the art. An appropriate protecting group (PG) may be used for an intermediate of formula XXXXIII (for example, a Cbz group as a proteccting group for an amine) for better functional group compatibility in the subsequent reaction. Treatment of an intermediate XXXXIII with POCl₃ provides a chloropyridazine intermediate XXXXIV. Reaction of a compound XXXXIV with hydrazine can be carried out at elevated temperature to provide an intermediate XXXXV. Acylation of an intermediate XXXXV with an acid XV using an appropriate set of amide coupling reagents such NMM/isobutylchloformate, EDAC/HOBT or other reagents described in “The Practice of Peptide Synthesis” (Spring-Verlag, 2^(nd) Ed., Bodanszy, Miklos, 1993) yields a hydrazide intermediate XXXXVI. Alternatively, a hydrazide XXXXVI can be prepared from the reaction of a compound XXXXV and an acid chloride XVI in the presence of an appropriate base such as DIEA or TEA. Formation of triazolopyridazine XXXXVII can be achieved from the reaction of XXXXVI with POCl₃ at an elevated temperature. Alternatively, formation of triazolopyridazine XXXXVII can also be achieved from XXXXVI in the presence of acetic acid at an elevated temperature, either under a conventional procedure or a microwave reactor. Forthermore, formation of triazolopyridazine XXXXVII can be achieved from the reaction of XXXXVI with Ph₃PCl₂ in the presence of a base such as TEA or by other methods known to one skilled in the art. The protecting group, if present, can be removed from a compound XXXXVII to provide an intermediate XXXXVIII (for more protecting group examples and conditions for their removal, see ‘Protective Groups in Organic Synthesis’ Greene at al., John Wiley and Sons Inc., 1991). Formation of a compound 1L can be achieved using reactions described in Schemes I to IV, or by other methods known to one skilled in the art.

An appropriate protecting group (PG) may be used for the intermediate compounds and/or functional groups (for example R₁, R_(1a), R_(1b), R_(1c), R_(1d), R_(2a), R_(2b), R_(2c), R_(2d), R₃ R_(3a), R_(3b), R₄, and L) described in Schemes I-X for better reaction compatibility. The protecting group, if present, can be removed to provide desired compound. For more protecting group examples and conditions for their removal, see “Protective Groups in Organic Synthesis”, Greene at al., John Wiley and Sons Inc., 1991.

Utilities and Combinations

A. Utilities

The compounds of the present invention possess activity as inhibitors of the enzyme 11-beta-hydroxysteroid dehydrogenase type I, and, therefore, may be used in the treatment of diseases associated with 11-beta-hydroxysteroid dehydrogenase type I activity. Via the inhibition of 11-beta-hydroxysteroid dehydrogenase type I, the compounds of the present invention may preferably be employed to inhibit or modulate glucocorticoid production, thereby interrupting or modulating cortisone or cortisol production.

Accordingly, the compounds of the present invention can be administered to mammals, preferably humans, for the treatment of a variety of conditions and disorders, including, but not limited to, treating, preventing, or slowing the progression of diabetes and related conditions, microvascular complications associated with diabetes, macrovascular complications associated with diabetes, cardiovascular diseases, Metabolic Syndrome and its component conditions, inflammatory diseases and other maladies. Consequently, it is believed that the compounds of the present invention may be used in preventing, inhibiting, or treating diabetes, hyperglycemia, impaired glucose tolerance, insulin resistance, hyperinsulinemia, retinopathy, neuropathy, nephropathy, delayed wound healing, atherosclerosis and its sequelae (acute coronary syndrome, myocardial infarction, angina pectoris, peripheral vascular disease, intermitant claudication), abnormal heart function, myocardial ischemia, stroke, Metabolic Syndrome, hypertension, obesity, dislipidemia, hyperlipidemia, hypertriglyceridemia, hypercholesterolemia, low HDL, high LDL, non-cardiac ischemia, infection, cancer, vascular restenosis, pancreatitis, neurodegenerative disease, lipid disorders, cognitive impairment and dementia, bone disease, HIV protease associated lipodystrophy, glaucoma and inflammatory diseases, such as, rheumatoid arthritis and osteoarthritis.

Metabolic Syndrome or “Syndrome X” is described in Ford, et al., J. Am. Med. Assoc. 2002, 287, 356-359 and Arbeeny, et al., Curr. Med. Chem. -Imm., Endoc. & Metab. Agents 2001, 1, 1-24.

B. Combinations

The present invention includes within its scope pharmaceutical compositions comprising, as an active ingredient, a therapeutically effective amount of at least one of the compounds of formula I, alone or in combination with a pharmaceutical carrier or diluent. Optionally, compounds of the present invention can be used alone, in combination with other compounds of the invention, or in combination with one or more other therapeutic agent(s), e.g., an antidiabetic agent or other pharmaceutically active material.

The compounds of the present invention may be employed in combination with other 11-beta-hydroxysteroid dehydrogenase type I inhibitors or one or more other suitable therapeutic agents useful in the treatment of the aforementioned disorders including: anti-diabetic agents, anti-hyperglycemic agents, anti-hyperinsulinemic agents, anti-retinopathic agents, anti-neuropathic agents, anti-nephropathic agents, anti-atherosclerotic agents, anti-ischemic agents, anti-hypertensive agents, anti-obesity agents, anti-dislipidemic agents, anti-dylsipidemic agents, anti-hyperlipidemic agents, anti-hypertriglyceridemic agents, anti-hypercholesterolemic agents, anti-restenotic agents, anti-pancreatic agents, lipid lowering agents, appetite suppressants, memory enhancing agents, cognition promoting agents and anti-inflammatory agents.

Examples of suitable anti-diabetic agents for use in combination with the compounds of the present invention include insulin and insulin analogs: LysPro insulin, inhaled formulations comprising insulin; glucagon-like peptides; sulfonylureas and analogs: chlorpropamide, glibenclamide, tolbutamide, tolazamide, acetohexamide, glypizide, glyburide, glimepiride, repaglinide, meglitinide; biguanides: metformin, phenformin, buformin; alpha2-antagonists and imidazolines: midaglizole, isaglidole, deriglidole, idazoxan, efaroxan, fluparoxan; other insulin secretagogues: linogliride, insulinotropin, exendin-4, BTS-67582, A-4166; thiazolidinediones: ciglitazone, pioglitazone, troglitazone, rosiglitazone; PPAR-gamma agonists; PPAR-alpha agonists; PPAR alpha/gamma dual agonists; SGLT2 inhibitors; dipeptidyl peptidase-IV (DPP4) inhibitors; glucagon-like peptide-1 (GLP-1) receptor agonists; aldose reductase inhibitors; RXR agonists: JTT-501, MCC-555, MX-6054, DRF2593, GI-262570,-KR-P-297, LG100268; fatty acid oxidation inhibitors: clomoxir, etomoxir; α-glucosidase inhibitors: precose, acarbose, miglitol, emiglitate, voglibose, MDL-25,637, camiglibose, MDL-73,945; beta-agonists: BRL 35135, BRL 37344, Ro 16-8714, ICI D7114, CL 316,243, TAK-667, AZ40140; phosphodiesterase inhibitors, both cAMP and cGMP type: sildenafil, L686398: L-386,398; amylin antagonists: pramlintide, AC-1 37; lipoxygenase inhibitors: masoprocal; somatostatin analogs: BM-23014, seglitide, octreotide; glucagon antagonists: BAY 276-9955; insulin signaling agonists, insulin mimetics, PTP1B inhibitors: L-783281, TER17411, TER17529; gluconeogenesis inhibitors: GP3034; somatostatin analogs and antagonists; antilipolytic agents: nicotinic acid, acipimox, WAG 994; glucose transport stimulating agents: BM-130795; glucose synthase kinase inhibitors: lithium chloride, CT98014, CT98023; and galanin receptor agonists.

Other suitable thiazolidinediones include Mitsubishi's MCC-555 (disclosed in U.S. Pat. No. 5,594,016), Glaxo-Wellcome's GL-262570, englitazone (CP-68722, Pfizer), or darglitazone (CP-86325, Pfizer, isaglitazone (MIT/J&J), JTT-501 (JPNT/P&U), L-895645 (Merck), R-119702 (Sankyo/WL), NN-2344 (Dr. Reddy/NN), or YM-440 (Yamanouchi).

Suitable PPAR alpha/gamma dual agonists include AR-HO39242 (Astra/Zeneca), GW-409544 (Glaxo-Wellcome), KRP297 (Kyorin Merck), as well as those disclosed by Murakami et al, “A Novel Insulin Sensitizer Acts As a Coligand for Peroxisome Proliferation—Activated Receptor Alpha (PPAR alpha) and PPAR gamma; Effect of PPAR alpha Activation on Abnormal Lipid Metabolism in Liver of Zucker Fatty Rats”, Diabetes 47, 1841-1847 (1998), and WO 01/21602, the disclosure of which is incorporated herein by reference, employing dosages as set out therein, which compounds designated as preferred are preferred for use herein.

Suitable alpha2 antagonists also include those disclosed in WO 00/59506, employing dosages as set out herein.

Suitable SGLT2 inhibitors include T-1095, phlorizin, WAY-123783, and those described in WO 01/27128.

Suitable DPP4 inhibitors include saxagliptan, sitagliptan, vildagliptan, and denagliptan.

Suitable aldose reductase inhibitors include those disclosed in WO

Suitable meglitinides include nateglinide (Novartis) or KAD1229 (PFiKissei).

Examples of GLP-1 receptor agonists include Exenatide (Byetta™), NN2211 (Liraglutide, Novo Nordisk), AVE0010 (Sanofi-Aventis), R1583 (Roche/Ipsen), SUN E7001 (Daiichi/Santory), GSK-716155 (GSK/Human Genome Sciences) and Exendin-4 (PC-DAC™).

Other anti-diabetic agents that can be used in combination with compounds of the invention include ergoset and D-chiroinositol.

Suitable anti-ischemic agents include, but are not limited to, those described in the Physician's Desk Reference and NHE inhibitors, including those disclosed in WO 99/43663.

Examples of suitable lipid lowering agents for use in combination with the compounds of the present invention include one or more MTP inhibitors, HMG CoA reductase inhibitors, squalene synthetase inhibitors, fibric acid derivatives, ACAT inhibitors, lipoxygenase inhibitors, cholesterol absorption inhibitors, ileal Na+/bile acid cotransporter inhibitors, upregulators of LDL receptor activity, bile acid sequestrants, cholesterol ester transfer protein inhibitors (e.g., CP-529414 (Pfizer)), and/or nicotinic acid and derivatives thereof.

MTP inhibitors which may be employed as described above include those disclosed in U.S. Pat. No. 5,595,872, U.S. Pat. No. 5,739,135, U.S. Pat. No. 5,712,279, U.S. Pat. No. 5,760,246, U.S. Pat. No. 5,827,875, U.S. Pat. No. 5,885,983, and U.S. Pat. No. 5,962,440.

The HMG CoA reductase inhibitors which may be employed in combination with one or more compounds of formula I include mevastatin and related compounds, as disclosed in U.S. Pat. No. 3,983,140, lovastatin, (mevinolin) and related compounds, as disclosed in U.S. Pat. No. 4,231,938, pravastatin, and related compounds, such as disclosed in U.S. Pat. No. 4,346,227, simvastatin, and related compounds, as disclosed in U.S. Pat. Nos. 4,448,784 and 4,450,171. Other HMG CoA reductase inhibitors which may be employed herein include, but are not limited to, fluvastatin, disclosed in U.S. Pat. No. 5,354,772; cerivastatin, as disclosed in U.S. Pat. Nos. 5,006,530 and 5,177,080; atorvastatin, as disclosed in U.S. Pat. Nos. 4,681,893, 5,273,945, 5,385,929 and 5,686,104; atavastatin (Nissan/Sankyo's nisvastatin (NK-104)), as disclosed in U.S. Pat. No. 5,011,930; visastatin (Shionogi-Astra/Zeneca (ZD-4522)) as disclosed in U.S. Pat. No. 5,260,440.

Preferred hypolipidemic agents are pravastatin, lovastatin, simvastatin, atorvastatin, fluvastatin, cerivastatin, atavastatin, and ZD-4522.

The fibric acid derivatives which may be employed in combination with one or more compounds of formula I include fenofibrate, gemfibrozil, clofibrate, bezafibrate, ciprofibrate, clinofibrate, and the like, probucol, and related compounds, as disclosed in U.S. Pat. No. 3,674,836, fenofibrate and gemfibrozil being preferred, bile acid sequestrants, such as cholestyramine, colestipol and DEAE-Sephadex (Secholex®, Policexide®), as well as lipostabil (Rhone-Poulenc), Eisai E-5050 (an N-substituted ethanolamine derivative), imanixil (HOE-402), tetrahydrolipstatin (THL), istigmastanylphosphorylcholine (SPC, Roche), aminocyclodextrin (Tanabe Seiyoku), Ajinomoto AJ-814 (azulene derivative), melinamide (Sumitomo), Sandoz 58-035, American Cyanamid CL-277,082 and CL-283,546 (disubstituted urea derivatives), nicotinic acid, acipimox, acifran, neomycin, p-aminosalicylic acid, aspirin, poly(diallylmethylamine) derivatives, such as disclosed in U.S. Pat. No. 4,759,923, quaternary amine poly(diallyldimethylammonium chloride) and ionenes, such as disclosed in U.S. Pat. No. 4,027,009, and other known serum cholesterol lowering agents.

The ACAT inhibitor which may be employed in combination with one or more compounds of formula I include those disclosed in Drugs of the Future 24, 9-15 (1999), (Avasimibe); “The ACAT inhibitor, Cl-1011 is effective in the prevention and regression of aortic fatty streak area in hamsters”, Nicolosi et al, Atherosclerosis (Shannon, Irel). (1998), 137(1), 77-85; “The pharmacological profile of FCE 27677: a novel ACAT inhibitor with potent hypolipidemic activity mediated by selective suppression of the hepatic secretion of ApoB100-containing lipoprotein”, Ghiselli, Giancarlo, Cardiovasc. Drug Rev. (1998), 16(1), 16-30; “RP 73163: a bioavailable alkylsulfinyl-diphenylimidazole ACAT inhibitor”, Smith, C., et al, Bioorg. Med. Chem. Lett. (1996), 6(1), 47-50; “ACAT inhibitors: physiologic mechanisms for hypolipidemic and anti-atherosclerotic activities in experimental animals”, Krause et al, Editor(s): Ruffolo, Robert R., Jr.; Hollinger, Mannfred A., Inflammation: Mediators Pathways (1995),173-98, Publisher: CRC, Boca Raton., Fla.; “ACAT inhibitors: potential anti-atherosclerotic agents”, Sliskovic et al, Curr. Med. Chem. (1994), 1(3), 204-25; “Inhibitors of acyl-CoA:cholesterol O-acyl transferase (ACAT) as hypocholesterolemic agents. 6. The first water-soluble ACAT inhibitor with lipid-regulating activity. Inhibitors of acyl-CoA:cholesterol acyltransferase (ACAT). 7. Development of a series of substituted N-phenyl-N′-[(1-phenylcyclopentyl)methyl]ureas with enhanced hypocholesterolemic activity”, Stout et al, Chemtracts: Org. Chem. (1995), 8(6), 359-62, or TS-962 (Taisho Pharmaceutical Co. Ltd.).

The hypolipidemic agent may be an upregulator of LDL receptor activity, such as MD-700 (Taisho Pharmaceutical Co. Ltd) and LY295427 (Eli Lilly).

Examples of suitable cholesterol absorption inhibitors for use in combination with the compounds of the invention include ezetimibe (Zetia®).

Examples of suitable ileal Na⁺/bile acid cotransporter inhibitors for use in combination with the compounds of the invention include compounds as disclosed in Drugs of the Future, 24, 425-430 (1999).

The lipoxygenase inhibitors which may be employed in combination with one or more compounds of formula I include 15-lipoxygenase (15-LO) inhibitors, such as benzimidazole derivatives, as disclosed in WO 97/12615, 15-LO inhibitors, as disclosed in WO 97/12613, isothiazolones, as disclosed in WO 96/38144, and 15-LO inhibitors, as disclosed by Sendobry et al “Attenuation of diet-induced atherosclerosis in rabbits with a highly selective 15-lipoxygenase inhibitor lacking significant antioxidant properties”, Brit. J. Pharmacology (1997) 120, 1199-1206, and Cornicelli et al, “15-Lipoxygenase and its Inhibition: A Novel Therapeutic Target for Vascular Disease”, Current Pharmaceutical Design, 1999, 5, 11-20.

Examples of suitable anti-hypertensive agents for use in combination with the compounds of the present invention include beta adrenergic blockers, calcium channel blockers (L-type and T-type; e.g. diltiazem, verapamil, nifedipine, amlodipine and mybefradil), diuretics (e.g., chlorothiazide, hydrochlorothiazide, flumethiazide, hydroflumethiazide, bendroflumethiazide, methylchlorothiazide, trichloromethiazide, polythiazide, benzthiazide, ethacrynic acid tricrynafen, chlorthalidone, furosemide, (e.g., aliskiren), ACE inhibitors (e.g., captopril, zofenopril, fosinopril, enalapril, ceranopril, cilazopril, delapril, pentopril, quinapril, ramipril, lisinopril), AT-1 receptor antagonists (e.g., losartan, irbesartan, valsartan), ET receptor antagonists (e.g., sitaxsentan, atrsentan, and compounds disclosed in U.S. Pat. Nos. 5,612,359 and 6,043,265), Dual ET/AII antagonist (e.g., compounds disclosed in WO 00/01389), neutral endopeptidase (NEP) inhibitors, vasopepsidase inhibitors (dual NEP-ACE inhibitors) (e.g., omapatrilat and germopatrilat), and nitrates.

Examples of suitable anti-obesity agents for use in combination with the compounds of the present invention include a cannabinoid receptor 1 antagonist or inverse agonist, a beta 3 adrenergic agonist, a lipase inhibitor, a serotonin (and dopamine) reuptake inhibitor, a thyroid receptor beta drug, and/or an anorectic agent.

Cannabinoid receptor 1 antagonists and inverse agonists which may be optionally employed in combination with compounds of the present invention include rimonabant, SLV 319, CP-945598 (Pfizer), SR-147778 (Sanofi-Aventis), MK0364 (Merck) and those discussed in D. L. Hertzog, Expert Opin. Ther. Patents 2004, 14, 1435-1452.

The beta 3 adrenergic agonists which may be optionally employed in combination with compounds of the present invention include AJ9677 (Takeda/Dainippon), L750355 (Merck), or CP331648 (Pfizer,) or other known beta 3 agonists, as disclosed in U.S. Pat. Nos. 5,541,204, 5,770,615, 5,491,134, 5,776,983, and 5,488,064, with AJ9677, L750,355, and CP331648 being preferred.

Examples of lipase inhibitors which may be optionally employed in combination with compounds of the present invention include orlistat or ATL-962 (Alizyme), with orlistat being preferred.

The serotonin (and dopoamine) reuptake inhibitor and/or modulator which may be optionally employed in combination with a compound of formula I may be sibutramine, topiramate (Johnson & Johnson), APD-356 (Arena) or axokine (Regeneron), with sibutramine and APD-356 being preferred.

Examples of thyroid receptor beta compounds which may be optionally employed in combination with compounds of the present invention include thyroid receptor ligands, such as those disclosed in WO97/21993 (U. Cal SF), WO99/00353 (KaroBio), and WO00/039077 (KaroBio), with compounds of the KaroBio applications being preferred.

The anorectic agent which may be optionally employed in combination with compounds of the present invention include dexamphetamine, phentermine, phenylpropanolamine, or mazindol, with dexamphetamine being preferred.

Other compounds that can be used in combination with the compounds of the present invention include CCK receptor agonists (e.g., SR-27895B); MCHR1 antagonist (e.g., GSK 856464); galanin receptor antagonists; MCR-4 antagonists (e.g., HP-228); leptin or mimetics; urocortin mimetics, CRF antagonists, and CRF binding proteins (e.g., RU-486, urocortin).

Further, the compounds of the present invention may be used in combination with HIV protease inhibitors, including but not limited to Reyataz® and Kaletra®.

Examples of suitable memory enhancing agents, anti-dementia agents, or cognition promoting agents for use in combination with the compounds of the present invention include, but are not limited to, donepezil, rivastigmine, galantamine, memantine, tacrine, metrifonate, muscarine, xanomelline, deprenyl and physostigmine.

Examples of suitable anti-inflammatory agents for use in combination with the compounds of the present invention include, but are not limited to, prednisone, acetaminophen, aspirin, codeine, fentaynl, ibuprofen, indomethacin, ketorolac, morphine, naproxen, phenacetin, piroxicam, a steroidal analgesic, sufentanyl, sunlindac, interferon alpha, prednisolone, methylprednisolone, dexamethazone, flucatisone, betamethasone, hydrocortisone, and beclomethasone.

The aforementioned patents and patent applications are incorporated herein by reference.

The above other therapeutic agents, when employed in combination with the compounds of the present invention may be used, for example, in those amounts indicated in the Physician's Desk Reference, as in the patents set out above, or as otherwise determined by one of ordinary skill in the art.

The compounds of formula I can be administered for any of the uses described herein by any suitable means, for example, orally, such as in the form of tablets, capsules, granules or powders; sublingually; bucally; parenterally, such as by subcutaneous, intravenous, intramuscular, or intrasternal injection, or infusion techniques (e.g., as sterile injectable aqueous or non-aqueous solutions or suspensions); nasally, including administration to the nasal membranes, such as by inhalation spray; topically, such as in the form of a cream or ointment; or rectally such as in the form of suppositories; in dosage unit formulations containing non-toxic, pharmaceutically acceptable vehicles or diluents.

In carrying out the method of the invention for treating diabetes and related diseases, a pharmaceutical composition will be employed containing the compounds of formula I, with or without other antidiabetic agent(s) and/or antihyperlipidemic agent(s) and/or other type therapeutic agents in association with a pharmaceutical vehicle or diluent. The pharmaceutical composition can be formulated employing conventional solid or liquid vehicles or diluents and pharmaceutical additives of a type appropriate to the mode of desired administration, such as pharmaceutically acceptable carriers, excipients, binders, and the like. The compounds can be administered to a mammalian patient, including humans, monkeys, dogs, etc. by an oral route, for example, in the form of tablets, capsules, beads, granules or powders. The dose for adults is preferably between 1 and 2,000 mg per day, which can be administered in a single dose or in the form of individual doses from 1-4 times per day.

A typical capsule for oral administration contains compounds of structure I (250 mg), lactose (75 mg), and magnesium stearate (15 mg). The mixture is passed through a 60 mesh sieve and packed into a No. 1 gelatin capsule.

A typical injectable preparation is produced by aseptically placing 250 mg of compounds of structure I into a vial, aseptically freeze-drying and sealing. For use, the contents of the vial are mixed with 2 mL of physiological saline, to produce an injectable preparation.

Assay(s) for 11-Beta-Hydroxysteroid Dehydrogenase Activity

The in vitro inhibition of recombinant human 11beta-HSD1 was determined as follows.

Recombinant human 11beta-HSD1 was expressed stably in HEK 293 EBNA cells. Cells were grown in DMEM (high glucose) containing MEM non-essential amino acids, L-glutamine, hygromycine B (200 ug/ml), and G418(200 ug/ml). The cell pellets were homogenized, and the microsomal fraction was obtained by differential centrifugation. 11beta-HSD1 over expressed microsomes were used as the enzyme source for the Scintillation Proximity Assay (SPA). The test compounds at the desired concentration were incubated at room temperature with 12.5 μg of microsomal enzyme, 250 nM [³H]-cortisone, 500 μM NADPH, 50 mM MES, pH 6.5, and 5 mM EDTA in 96-well OptiPlates. The reaction was terminated with the addition of 1 mM 18β-glycerrhentic acid. SPA reagent mixture (YSi anti-rabbit IgG, anti-cortisol antibody in 50 mM Tris, pH 8.0 containing 1% CHAPS and 1% glycerol) was added and the reaction was further incubated at room temperature over night and counted in TopCount. The IC₅₀ (concentration of compound required for 50% inhibition of cortisol formation) was determined using XLfit.

In general, preferred compounds of the present invention, such as particular compounds disclosed in the following examples, have been identified to inhibit the catalytic activity of 11-beta-hydroxysteroid dehydrogenase type I at concentrations equivalent to, or more potently than, 10 μM, preferably 5 μM, more preferably 3 μM, thereby demonstrating compounds of the present invention as especially effective inhibitors of 11-beta-hydroxysteroid dehydrogenase type I. Potencies can be calculated and expressed as either inhibition constants (Ki values) or as IC50 (inhibitory concentration 50%) values, and refer to activity measured employing the assay system described above.

EXAMPLES

The following working Examples serve to better illustrate, but not limit, some of the preferred embodiments of the present invention.

General

The term HPLC refers to a Shimadzu high performance liquid chrtomatography with one of following methods:

Method A: YMC or Phenomenex C18 5 micron 4.6×50 mm column using a 4 minute gradient of 0-100% solvent B [90% MeOH:10% H₂O:0.2% H₃PO₄] and 100-0% solvent A [10% MeOH:90% H₂O:0.2% H₃PO₄] with 4 mL/min flow rate and a 1 min. hold, an ultra violet (UV) detector set at 220 nm.

Method B: Phenomenex S5 ODS 4.6×30 mm column, gradient elution 0-100% B/A over 2 min (solvent A=10% MeOH/H₂O containing 0.1% TFA, solvent B=90% MeOH/H₂O containing 0.1% TFA), flow rate 5 mL/min, UV detection at 220 nm.

Method C: YMC S7 ODS 3.0×50 mm column, gradient elution 0-100% B/A over 2 min (solvent A=10% MeOH/H₂O containing 0.1% TFA, solvent B=90% MeOH/H₂O containing 0.1% TFA), flow rate 5 mL/min, UV detection at 220 nm.

The term prep HPLC refers to an automated Shimadzu HPLC system using a mixture of solvent A (10% MeOH/90% H₂O/0.2% TFA) and solvent B (90% MeOH/10% H₂O/0.2% TFA). The preparative columns were packed with YMC or Phenomenex ODS C18 5 micron resin or equivalent.

Abbreviations

The following abbreviations are employed in the Examples and elsewhere herein:

-   Ph=phenyl -   Bn=benzyl -   i-Bu=iso-butyl -   Me=methyl -   Et=ethyl -   Pr=propyl -   Bu=butyl -   AIBN=2,2′-Azobisisobutyronitrile -   Boc or BOC=tert-butoxycarbonyl -   Cbz=carbobenzyloxy or carbobenzoxy or benzyloxycarbonyl -   DCM=dichloromethane -   DEAD=Diethyl azodicarboxylate -   DIAD=Diisopropyl azodicarboxylate -   DIEA=N,N-diisopropylethylamine -   DMA=N,N-dimethylacetylamide -   DMF=N,N-dimethylformamide -   DMSO=dimethylsulfoxide -   EtOAc=ethyl acetate -   EDAC=3-ethyl-3′-(dimethylamino)propyl-carbodiimide hydrochloride (or     1-[(3-(dimethyl)amino)propyl])-3-ethylcarbodiimide hydrochloride) -   FMOC=fluorenylmethoxycarbonyl -   HOAc or AcOH=acetic acid -   HOAT=1-hydroxy-7-azabenzotriazole -   HOBT=1-hydroxybenzotriazole -   LAH=lithium aluminum hydride -   mCPBA=3-Chloroperoxybenzoic acid -   NMM=N-methyl morpholine -   NBS=N-Bromosuccinimide -   n-BuLi=n-butyllithium -   Oxone®=Monopersulfate -   Pd/C=palladium on carbon -   PtO₂=platinum oxide -   PyBOP reagent=benzotriazol-1-yloxy-tripyrrolidino phosphonium     hexafluorophosphate -   SOCl₂=Thionyl chloride -   TBAF=tetrabutylammonium fluoride -   TBS=tert-Butyldimethylsilyl -   TMS=trimethylsilyl -   TEA=triethylamine -   TFA=trifluoroacetic acid -   THF=tetrahydrofuran -   equiv=equivalent(s) -   min=minute(s) -   h or hr=hour(s) -   L=liter -   mL=milliliter -   Li=microliter -   g=gram(s) -   mg=milligram(s) -   mol=mole(s) -   mmol=millimole(s) -   meq=milliequivalent -   RT=room temperature -   sat or sat'd=saturated -   aq.=aqueous -   TLC=thin layer chromatography -   HPLC=high performance liquid chromatography -   HPLC R_(t)=HPLC retention time -   LC/MS=high performance liquid chromatography/mass spectrometry -   MS or Mass Spec=mass spectrometry -   NMR=nuclear magnetic resonance -   mp=melting point

EXAMPLE 1 3-Cycloheptyl-8-((2,6-dichlorophenoxy)methyl)H-imidazo[1,5-a]pyridine

Compound 1A: 3-(Bromomethyl)picolinonitrile

To a solution of 3-methylpicolinonitrile (660 mg, 5.6 mmol) in 20 mL of carbon tetrachloride was added NBS (1 g, 5.6 mmol) and dibenzoyl peroxide (200 mg, 0.83 mmol) at RT. The reaction mixture was heated at 80° C. for 2 hr, and then cooled to RT. The resulting solid was filtered off, and the filtrate was concentrated under reduced pressure to provide a residue. The residue was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated under reduced pressure to provide crude material. The crude material was purified via silica gel chromatography (10% ethyl acetate in hexanes) to provide compound 1A (510 mg, 46%) as a pale yellow oil. HPLC R_(t) (Method A): 1.72 min. LC/MS (m/z)=197 (M+H)⁺.

Compound 1B: 3-((2,6-Dichlorophenoxy)methyl)picolinonitrile

To a solution of 2,6-dichlorophenol (620 mg, 3.8 mmol) in 5 mL of anhydrous acetone was added potassium carbonate (520 mg, 3.8 mmol) and compound 1A (500 mg, 2.54 mmol) at RT. The reaction mixture was stirred at RT for 2 hr, and the resulting solid was filtered off. The solvent was removed from the filtrate in vacuo to provide a residue. The residue was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated to provide crude material. The crude material was purified via silica gel chromatography using 10% ethyl acetate in hexanes to provide compound 1B (530 mg, 50%) as a white solid. HPLC R_(t) (Method A): 3.23 min. LC/MS (m/z)=279 (M+H)⁺ and 301 (M+Na)⁺.

Compound 1C: (3-((2,6-Dichlorophenoxy)methyl)pyridin-2-yl)methanamine

To a solution of compound 1B (500 mg, 1.8 mmol) in 4 mL of anhydrous THF was added LAH (1.8 mL, 1.8 mmol, 1 M in THF) at −10° C. under nitrogen. The reaction mixture was stirred at 0° C. for 1 hr and quenched with water. The THF was removed in vacuo, and the reaction mixture was diluted with ethyl acetate, washed with water, dried over Na₂SO₄, and concentrated under reduced pressure to provide compound 1C (500 mg) as a brown oil. HPLC R_(t) (Method A): 2.43 min. LC/MS (m/z)=283 (M+H)⁺.

Compound 1D: N-((3-((2,6-Dichlorophenoxy)methyl)pyridin-2-yl)methyl)cycloheptane-carboxamide

To a solution of cycloheptanecarboxylic acid (255 mg, 1.8 mmol) in 3 mL of anhydrous THF was added NMM (0.24 mL, 2.2 mmol), followed by addition of iso-butyl chloroformate (0.285 mL, 2.2 mmol) at 0° C. under nitrogen. The reaction mixture was stirred at 0° C. for 30 min. After this time, a solution of compound 1C (500 mg, previous step) in 2 mL of THF was added. The resulting mixture was stirred at 0° C. for 30 min followed by stirring for 30 min at RT. The mixture was quenched with water, and the solvent was removed in vacuo to yield a residue. The residue was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated under reduced pressure to yield crude material. The crude material was purified via silica gel chromatography using 30% ethyl acetate in hexanes to provide compound ID (50 mg, 7%) as a yellow solid. HPLC R_(t) (Method A): 3.56 min. LC/MS (m/z)=407 (M+H)⁺.

EXAMPLE 1

To a solution of compound 1D (50 mg, 0.12 mmol) in 2 mL of anhydrous toluene was added POCl₃ (23 μL, 0.25 mmol) at RT. The reaction mixture was heated at 100° C. for 3 hr, cooled to RT and quenched with water. The reaction mixture was then diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated under reduced pressure to yield crude product. The crude product was purified via PrepHPLC to provide Example 1 as a colorless oil (43 mg, 66%). HPLC R_(t) (Method A): 3.00 min. LC/MS (m/z)=389 (M+H)⁺. ¹H NMR: δ 8.01 (s, 1H), 7.90 (d, J=7 Hz, 1H), 7.34 (d, J=8 Hz, 2H), 7.29 (d, J=7 Hz, 1H), 7.08 (t, J=8 Hz, 1H), 7.02 (t, J=7 Hz, 1H), 5.17 (s, 2H), 3.39-3.50 (m, 1H), 2.02-2.18 (m, 4H), 1.88-2.00 (m, 2H), 1.56-1.78 (m, 6H).

EXAMPLE 2 3-Cycloheptyl-8-((2,6-dichlorophenoxy)methyl)H-imidazo[1,2-a]pyridine

Compound 2A: 2-Bromo-1-cycloheptylethanone

To a solution of cycloheptanecarboxylic acid (1.5 g, 10.5 mmol) in 5 mL of dichloromethane was added oxalyl chloride (10.5 mL, 21 mmol, 2 M in dichloromethane), followed by addition of several drops of DMF at RT. The reaction mixture was stirred at RT for 1 hr, and then concentrated under reduced pressure to yield an oil. The oil was dissolved in 10 mL of anhydrous THF. The resulting solution was cooled to 0° C. and a solution of trimethylsilyl diazomethane (6.8 mL, 13.6 mmol, 2 M in diethyl ether) was added at 0° C. Upon completion of addition, the mixture was stirred at 0° C. overnight. At the conclusion of this period, an 48% aqueous HBr solution (2.4 mL, 80.9 mmol) was added at 0° C., and the reaction mixture was stirred for 2 hr at 0° C. The reaction mixture was then quenched with 20% aqueous sodium carbonate. The solvent was removed in vacuo to yield a residue. The residue was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated in vacuo to yield the crude material. The crude material was purified via silica gel chromatography using 5% ethyl acetate in hexanes to provide compound 2A (1 g, 43%) as a pale yellow oil. HPLC R_(t) (Method A): 3.27 min. LC/MS (m/z)=219 (M+H)⁺ and 241 (M+Na)⁺.

Compound 2B: (3-CycloheptylH-imidazo[1,2-a]pyridin-8-yl)methanol

To a solution of (2-aminopyridin-3-yl)methanol (185 mg, 1.5 mmol) in 5 mL of anhydrous ethanol was added compound 2A (250 mg, 1.1 mmol) at RT. The reaction mixture was heated at 80° C. for 10 hr, cooled to RT and then concentrated under reduced pressure to yield a residue. The residue was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated to yield crude material. The crude material was purified via silica gel chromatography using 30-50% ethyl acetate in hexanes to provide compound 2B (160 mg, 57%) as a white solid. HPLC R_(t) (Method A): 1.76 min. LC/MS (m/z)=245 (M+H)⁺.

EXAMPLE 2

To a solution of compound 2B (73 mg, 0.3 mmol) in 2 mL of anhydrous THF was added 2,6-dichlorophenol (98 mg, 0.6 mmol), triphenylphosphine (157 mg, 0.6 mmol) and DEAD (105 mg, 0.6 mmol) at RT. The reaction mixture was stirred at RT for 2 hr, and then concentrated under reduced pressure. The concentrated reaction mixture was diluted with ethyl acetate, washed with water, dried over Na₂SO₄ and concentrated under reduced pressure to yield crude product. The crude product was purified via silica gel chromatography using 30% ethyl acetate in hexanes followed by PrepHPLC to yield Example 2 as a pale-yellow oil (56 mg, 37%). HPLC R_(t) (Method A): 3.00 min. LC/MS (m/z)=389 (M+H)⁺. ¹H NMR: δ 8.25 (d, J=8 Hz, 1H), 8.20 (d, J=8 Hz, 1H), 7.46 (d, J=1 Hz, 1H), 7.35 (t, J=8 Hz, 2H), 7.31 (d, J=8 Hz, 1H), 7.04 (t, J=8 Hz, 1H), 5.57 (s, 2H), 3.15-3.25 (m, 1H), 2.08-2.18 (m, 2H), 1.50-1.80 (m, 10H).

EXAMPLE 3 3-Cycloheptyl-7-((2,6-dichlorophenoxy)methyl)-[1,2,3]triazolo[1,5-a]pyridine

Compound 3A: (6-Bromopyridin-2-yl)(cycloheptyl)methanone

To a dry three-neck round bottom flask was added 30 mL of THF. The flask was cooled to −78° C., and n-butyllithium (16.9 mL, 42.2 mmol, 2.5 N in hexanes) was added to the flask in one portion. A solution of 2,6-dibromopyridine (10 g, 42.2 mmol) in 70 mL of THF was slowly added via an addition funnel at −78° C. to provide a dark green solution. Upon completion of addition, the mixture was stirred for an additional 15 min at −78° C. To the dark green solution at −78° C. was added cycloheptyl nitrile over 1 min. The reaction mixture was then warmed to RT. Once at the prescribed temperature, a solution of 6N HCl (55 mL, 330 mmol) was added, and the reaction mixture was heated to reflux for 5 min, followed by stirring at RT for 30 min. The resulting solution was made basic by adding 1N NaOH at 0° C. The resulting mixture was extracted with ethyl acetate, dried over MgSO₄ and concentrated to yield crude material. The crude material was purified via silica gel chromatography using 5% ethyl acetate in hexanes to provide compound 3A (6.8 g, 57%) as a yellow oil. HPLC Rt (Method A): 4.09 min. LC/MS (m/z)=283 (M+H)⁺.

Compound 3B: (Z)-N′-((6-bromopyridin-2-yl)(cycloheptyl)methylene)4-methylbenzenesulfonohydrazide

To a solution of p-tolylsulfonhydrazide (3.7 g, 19.85 mmol) in 25 mL of warm methanol was added a solution of compound 3A (5.6 g, 19.85 mmol) in 2 mL methanol. The mixture was swirled to ensure that it was homogenous. The reaction mixture was stirred at RT for 1h, heated at 50° C. for 2.5 h, and then cooled to RT. To the reaction mixture was added 15 mL of water. The resulting mixture was warmed to about 60° C. effect dissolution. The compound 3B (7.5 g, 84%) was recrystallized from the solution to give a white powder containing both the cis and the trans isomers. HPLC R_(t) (Method A): 3.93, 4.03 min. LC/MS (m/z)=450 (M+H)⁺.

Compound 3C: 7-Bromo-3-cycloheptyl-[1,2,3]triazolo[1,5-a]pyridine

A solution of compound 3B (5.5 g, 12.21 mmol) was treated with 20 mL of morpholine at 95° C. for 40 min. The reaction mixture was concentrated under reduced pressure and purified via silica gel chromatography using 20% ethyl acetate in hexanes to provide compound 3C (710 mg, 20%) as a colorless oil. HPLC R_(t) (Method A): 3.47 min. LC/MS (m/z)=294 (M+H)⁺.

Compound 3D: Methyl 3-cycloheptyl-[1,2,3]triazolo[1,5-a]pyridine-7-carboxylate

Compound 3C (270 mg, 0.92 mmol), palladium acetate (103 mg, 0.46 mmol), 1,3-bis(diphenylphosphino)propane (152 mg, 0.368 mmol), DBU (168 mg, 1.104 mmol), methanol (2.5 mL), and DMF (2.5 mL) were combined in a sealed steel autoclave vessel. The autoclave vessel was then connected to a carbon monoxide lecture bottle. The vessel was filled with carbon monoxide gas to 70 psi, heated at 85° C. for 1.5 h, and then cooled to RT. The reaction mixture was then diluted with ethyl acetate. The resulting solid was filtered off. The filtrate was washed with water, dried over with MgSO₄, and concentrated under reduced pressure to yield crude material. The crude material was purified via silica gel chromatography using 10-20% ethyl acetate in hexanes to provide compound 3D (188 mg, 75%) as a colorless oil. HPLC R_(t) (Method A): 3.30 min. LC/MS (m/z)=274 (M+H)⁺.

Compound 3E: (3-Cycloheptyl-[1,2,3]triazolo[1,5-a]pyridin-7-yl)methanol

A solution of compound 3D (185 mg, 0.68 mmol) in 5 mL of methanol was treated with NaBH₄ (154 mg, 4.06 mmol) at RT for 5 min. The reaction flask became hot. The reaction mixture was quenched with water and then extracted with ethyl acetate. The ethyl acetate extract was dried over MgSO₄ and concentrated under reduced pressure to yield crude material. The crude material was purified via silica gel chromatography using 20-50% ethyl acetate in hexanes to provide compound 3E (123 mg, 74%) as a white powder. HPLC R_(t) (Method A): 3.19 min. LC/MS (m/z)=246 (M+H)⁺.

EXAMPLE 3

Example 3 (66 mg, 92%, white powder) was prepared from compound 3E in a similar manner as described for the preparation of Example 2 from compound 2B. HPLC R_(t) (Method A): 4.26 min. LC/MS (m/z)=390 (M+H)⁺. ¹H NMR: δ 7.72 (d, J=8 Hz, 1H), 7.44 (d, J=1 Hz, 1H), 7.37 (d, J=8 Hz, 2H), 7.26-7.32 (m, 1H), 7.10 (t, J=8 Hz, 1H), 5.68 (s, 2H), 3.30-3.40 (m, 1H), 1.96-2.15 (m, 4H), 1.83-1.93 (m, 2H), 1.60-1.82 (m, 6H).

EXAMPLE 4 1-Cycloheptyl-4-((2,6-dichlorophenoxy)methyl)-1H-benzo[d][1,2,3]triazole

Compound 4A: Azidocycloheptane

To a 250 mL round bottle flask containing cycloheptyl bromide (10 g, 56.47 mmol) in 30 mL of THF was added trimethylsilyl azide (9.76 g, 84.7 mmol), followed by addition of a solution of 1.0 N TBAF in THF (84.7 mL, 84.7 mmol). The reaction mixture was heated at 70° C. for 6 h. After this time, the solvent was removed under reduced pressure, and the reaction mixture was purified via silica gel chromatography using pentane to provide compound 4A (7.10 g, 90%) as a colorless oil.

Compound 4B: 4-Chloro-1-cycloheptyl-1H-benzo[d][1,2,3]triazole

A solution of compound 4A (3.3 g, 23.4 mmol) and isoamyl nitrite (3.14 mL, 23.4 mmol) in 80 mL of dichloroethane was heated to reflux, and a solution of 2-amino-3-chlorobenzoic acid (2g, 11.7 mmol) in 30 mL of acetone was added dropwise in 2 h. Upon completion of addition, the reaction mixture was heated for another 2 h, and then cooled to RT. The reaction mixture was then concentrated under reduced pressure to yield a residue. The residue was partitioned between ethyl acetate and aqueous 1N NaOH. The organic layer was separated, washed with 1N NaOH and water, dried over MgSO₄, and concentrated under reduced pressure to yield crude material. The crude material was purified via silica gel chromatography using 10-30% ethyl acetate in hexanes to provide compound 4B (0.6 g, 21%) as a white powder. HPLC R_(t) (Method A): 3.48 min. LC/MS (m/z)=250 (M+H)⁺.

Compound 4C: 1-Cycloheptyl-1H-benzo[d][1,2,3]triazole-4-carboxamide

Compound 4B (0.4 g, 1.60 mmol) and copper cyanide (0.43 g, 4.80 mmol) were suspended in 5 mL of wet 1-methyl-2-pyrrolidinone and heated at 205° C. for 4 days in a sealed pressure tube. After the mixture was cooled to RT, water was added. The resulting powders were collected on a filter funnel, suspended in a mixture of solvents (methanol, chloroform and dichloromethane), and stirred overnight. The resulting mixture was passed through a filter funnel, and the liquid portion was concentrated under reduced pressure to provide crude material. The crude material was purified via silica gel chromatography using 10-50% ethyl acetate in hexanes to provide compound 4C (0. 1 3 g, 34%) as a white powder. HPLC R_(t) (Method A): 3.08 min. LC/MS (m/z)=259 (M+H)⁺.

Compound 4D: 1-Cycloheptyl-1H-benzo[d][1,2,3]triazole4-carboxylic acid

To a stirred solution of compound 4C (40 mg, 0.155 mmol) in 1 mL of 75% sulfuric acid was added dropwise 0.5 mL of aqueous solution of sodium nitrite (107 mg, 1.55 mmol) at 70° C. The reaction mixture was poured into 5 mL of ice water, filtered and dried under vacuum to provide compound 4D (38 mg, 95%) as a white powder. HPLC R_(t) (Method A): 3.00 min. LC/MS (m/z)=260 (M+H)⁺.

Compound 4E: (1-Cycloheptyl-1H-benzo[d][1,2,3]triazol-4-yl)methanol

Compound 4D (14 mg, 0.054 nmol) was dissolved in 1.5 mL of THF and treated with a solution of 2 N borane dimethylsulfide in THF (0.14 mL, 0.27 mmol) at RT overnight. At the conclusion of this period, small pieces of ice were added to the reaction mixture until all gas evolution stopped. The reaction mixture was then stirred at RT for 3 h. After this time, the reaction mixture was diluted with ethyl acetate., washed with a diluted bleach solution, dried over MgSO₄ and concentrated under reduced pressure to yield crude material. The crude material was purified via silica gel chromatography using 5% methanol in ethyl acetate to provide compound 4E (9 mg, 68%) as a colorless oil. HPLC R_(t) (Method A): 3.00 min. LC/MS (m/z)=246 (M+H)⁺.

EXAMPLE 4

Example 4 (8.5 mg, 59%, white powder) was prepared from compound 4E in a similar manner as described for the preparation of Example 2 from compound 2B. HPLC R_(t) (Method A): 4.22 min. LC/MS (m/z)=390 (M+H)⁺. ¹H NMR: δ 7.69 (dd, J=5, 3 Hz, 1H), 7.44-7.46 (m, 2H), 7.26 (d, J=8 Hz, 2H), 6.95 (t, J=8 Hz, 1H), 5.65 (s, 2H), 4.79-4.91 (m, 1H), 2.08-2.32 (m, 4H), 1.79-1.93 (m, 2H), 1.51-1.77 (m, 6H).

EXAMPLES 5 TO 11

Examples 5 to 11 in Table 1 were synthesized according to the procedures described described in Examples 1 to 4, or by other similar methods known to one skilled in the art, with other appropriate reagents. TABLE 1 Example Structure LC/MS Mass (M + H) HPLC purity (%) 5

407 95 6

392 97 7

390 96 8

406 97 9

376 98 10

392 98 11

301 95 

1. A compound of formula (I) W-L-Z   (I) enantiomers, diastereomers, solvates, salts or prodrugs thereof wherein: W is aryl, cycloalkyl, heteroaryl or heterocyclyl, all of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or alternatively any two R₁, R_(1a), R_(1b), R_(1c) and R_(1d) can be taken together to form a fused aryl, heteroaryl, heterocyclyl ring or spiro heterocyclyl ring; L is a bond, O, S, SO, SO₂, alkenyl, cycloalkyl, NR₅, CR₂R_(2a), CR₂R_(2a)CR_(2b)R_(2c), SO₂NR₂, OCR₂R_(2a), OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R_(2c)CR₂R_(2a)O, N(R₅)CR₂R_(2a), CR₂R_(2a)N(R₅), SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)SO, CR₂R_(2a)SO₂, SOCR₂R_(2a), SO₂CR₂R_(2a), CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c), CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a), CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S, CR₂R_(2a)CR_(2b)R_(2c)SO, CR₂R_(2a)CR_(2b)R_(2c)SO₂, provided that L is not a bond when W is phenyl; R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; or alternatively any two R₂, R_(2a), R_(2b), and R_(2c) can be taken together to which the atom they are attached to form a cycloalkyl, halogen substituted cycloalkyl or heterocyclyl ring; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —CO₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is alkyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroayl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); R_(4a) is hydrogen, CN, alkyl, haloalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl; R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a), or SO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol; excluding compounds having the formula:

wherein W is phenyl, said phenyl is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, alkyl or haloalkyl; L is CH₂, O, S or SO₂; and R₄ is C₃₋₁₀cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, OH, CN, —NHCOR₆, —NHSO₂R₆, C₁₋₆alkyl, perhaloC₁₋₆alkyl, C₁₋₆alkoxy, perhaloC₁₋₆alkoxy, C₁₋₁₀heterocyclyl, C₁₋₁₀heteroaryl or phenyl; or R₄ is C₁₋₁₀heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, OH, CN, —NHCOR₆, —NHSO₂R₆, C₁₋₆alkyl, perhaloC₁₋₆alkyl, C₁₋₆alkoxy, perhaloC₁₋₆alkoxy, C₁₋₁₀heterocyclyl, C₁₋₁₀heteroaryl or phenyl; or R₄ is C₁₋₆alkyl, which may be optionally substituted with one or more substituents selected from halogen, OH, CN, —NHCOR₆, —NHSO₂R₆, C₁₋₆alkyl, perhaloC₁₋₆alkyl, C₁₋₆alkoxy, perhaloC₁₋₆alkoxy, C₁₋₁₀heterocyclyl, C₁₋₁₀heteroaryl or phenyl.
 2. The compound of claim 1, wherein W is aryl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d).
 3. The compound of claim 1, wherein W is phenyl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d).
 4. The compound of claim 1, wherein Z is selected from the following bicyclic heteroaryl groups:


5. The compound of claim 1, wherein Z is selected from the following bicyclic heteroaryl groups:


6. The compound of claim 1, wherein: R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1 ]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a), or SO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 7. The compound of claim 1, wherein: Z is selected from the following bicyclic heteroaryl groups:

R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a), or SO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 8. The compound of claim 1, wherein: W is aryl, cycloalkyl or heteroaryl, all of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, SO₂, CR₂R_(2a), SO₂NR₂, OCR₂R_(2a), OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R_(2c)CR₂R_(2a)O, SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)SO, CR₂R_(2a)SO₂, SO₂CR₂R_(2a), CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c), CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a), CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S, CR₂R_(2a)CR_(2b)R_(2c)SO, or CR₂R_(2a)CR_(2b)R_(2c)SO₂; R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R_(4a) is hydrogen, alkyl, or haloalkyl; R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a)or CO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R₇a R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 9. The compound of claim 1, wherein: W is aryl, cycloalkyl or heteroaryl, all of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, SO, SO₂, NR₂, CR₂R_(2a), CR₂R_(2a)CR_(2b)R_(2c), OCR₂R_(2a), CR₂R_(2a)O, SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c), CR₂R_(2a)SO₂CR_(2b)R_(2c) or SO₂NR₂CR_(2a)R_(2b); R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, OCONR₂R_(2a), CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 10. The compound of claim 1, wherein: W is aryl or heteroaryl, both of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O, SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c); R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 11. The compound of claim 1, wherein: W is aryl or heteroaryl, both of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O, SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c); R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —CO₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylarino, arylcarbonylamino, —NO₂, —CN or thiol.
 12. The compound of claim 1, wherein: W is aryl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, SO, SO₂, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O, SO₂NR₂CR_(2a)R_(2b) or CR₂R_(2a)OCR_(2b)R_(2c); R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₅, —CO₂R₆, —CO₂H, —CONR₂R_(2a), —SO₂R₆, alkyl, alkoxy, nryv, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 13. The compound of claim 1, wherein: W is aryl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); L is a bond, O, S, CR₂R_(2a), OCR₂R_(2a), CR₂R_(2a)O or CR₂R_(2a)OCR_(2b)R_(2c); R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, —COR₆, —CO₂R₆, —CO₂H, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl; and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 14. The compound of claim 1, wherein: W is phenyl, which is optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl; L is O, S, SCH₂, OCH₂, CH₂O or CH₂OCH₂; Z is selected from the following bicyclic heteroaryl groups:

R₃, R₃₈ and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, aryl, heteroaryl or heterocyclyl; R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, all which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —CN, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl; and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylalkyl, cycloalkyl, amino, —OH, hydroxyalkyl, heteroaryl, heteroaryloxy, heteroarylalkyl, alkylthio, arylalkylthio, —NO₂, or —CN.
 15. The compound of claim 1, wherein L is O.
 16. A compound selected from the compounds exemplified in Examples 1 to
 11. 17. A pharmaceutical composition comprising a compound of claim
 1. 18. The pharmaceutical composition of claim 17 further comprising a pharmaceutically acceptable carrier.
 19. The pharmaceutical composition of claim 17 further comprising at least one additional therapeutic agent.
 20. The pharmaceutical composition of claim 17, wherien the compound of Formula (I) is present in a a therapeutically effective amount.
 21. A method for treating, preventing, or slowing the progression of a disease requiring 11-beta-hydroxysteroid dehydrogenase type I inhibitor therapy, which comprises administering to a mammalian patient in need of treatment a therapeutically effective amount of a compound of formula I W-L-Z   (I) enantiomers, diastereomers, solvates, salts or prodrugs thereof wherein: W is aryl, cycloalkyl, heteroaryl or heterocyclyl, all of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or alternatively any two R₁, R_(1a), R_(1b), R_(1c) and R_(1d) can be taken together to form a fused aryl, heteroaryl, heterocyclyl ring or spiro heterocyclyl ring; L is a bond, O, S, SO, SO₂, alkenyl, cycloalkyl, NR₅, CR₂R_(2a), CR₂R_(2a)CR_(2b)R_(2c), SO₂NR₂, OCR₂R_(2a), OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R_(2c)CR₂R_(2a)O, N(R₅)CR₂R_(2a), CR₂R_(2a)N(R₅), SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)SO, CR₂R_(2a)SO₂, SOCR₂R_(2a), SO₂CR₂R_(2a), CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c), CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a), CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S, CR₂R_(2a)CR_(2b)R_(2c)SO, CR₂R_(2a)CR_(2b)R₂CSO₂, provided that L is not a bond when W is phenyl; R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; or alternatively any two R₂, R_(2a), R_(2b), and R_(2c) can be taken together to which the atom they are attached to form a cycloalkyl, halogen substituted cycloalkyl or heterocyclyl ring; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is alkyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); R_(4a) is hydrogen, CN, alkyl, haloalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl; R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a), or SO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol.
 22. The method according to claim 21 further comprising administering, concurrently or sequentially, a therapeutically effective amount of at least one additional therapeutic agent selected from the group consisting of other compounds of formula I, an anti-diabetic agent, an anti-hyperglycemic agent, an anti-hyperinsulinemic agent, an anti-retinopathic agent, an anti-neuropathic agent, an anti-nephropathic agent, an anti-atherosclerotic agent, an anti-ischemic agent, an anti-hypertensive agent, an anti-obesity agent, an anti-dislipidemic agent, an anti-hyperlipidemic agent, an anti-hypertriglyceridemic agent, an anti-hypercholesterolemic agent, an anti-restenotic agent, an anti-pacreatic agent, a lipid lowering agent, an appetite suppressant, a memory enhancing agent, a cognition promoting agent and an anti-inflammatory agent.
 23. A method for treating, preventing, or slowing the progression of diabetes, hyperglycemia, obesity, dislipidemia, hypertension, cognitive impairment, rheumatoid arthritis, osteoarthritis, glaucoma, and Metabolic Syndrome, which comprises administering to a mammalian patient in need of treatment a therapeutically effective amount of a compound of claim
 1. 24. The method according to claim further comprising administering, concurrently or sequentially, a therapeutically effective amount of at least one additional therapeutic agent selected from the group consisting of other compounds of formula I, an anti-diabetic agent, an anti-hyperglycemic agent, anti-obesity agents, an anti-dislipidemic agent, a cognition promoting agent and an anti-inflammatory agent.
 25. A method of inhibiting the enzyme 11-beta-hydroxysteroid dehydrogenase type I which comprises administering to a mammalian patient in need of treatment a therapeutically effective amount of a compound of the formula I W-L-Z   (I) enantiomers, diastereomers, solvates, salts or prodrugs thereof wherein: W is aryl, cycloalkyl, heteroaryl or heterocyclyl, all of which may be optionally substituted with R₁, R_(1a), R_(1b), R_(1c) and R_(1d); R₁, R_(1a), R_(1b), R_(1c) and R_(1d) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂R₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylamino, aryl, heteroaryl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or alternatively any two R₁, R_(1a), R_(1b), R_(1c) and R_(1d) can be taken together to form a fused aryl, heteroayl, heterocyclyl ring or spiro heterocyclyl ring; L is a bond, O, S, SO, SO₂, alkenyl, cycloalkyl, NR₅, CR₂R_(2a), CR₂R_(2a)CR_(2b)R_(2c), SO₂NR₂, OCR₂R_(2a), OCR₂R_(2a)CR_(2b)R_(2c), CR₂R_(2a)O, CR_(2b)R₂CCR₂R_(2a)O, N(R₅)CR₂R_(2a), CR₂R_(2a)N(R₅), SCR₂R_(2a), CR₂R_(2a)S, CR₂R_(2a)SO, CR₂R_(2a)SO₂, SOCR₂R_(2a), SO₂CR₂R_(2a), CR₂R_(2a)OCR_(2b)R_(2c), CR₂R_(2a)SCR_(2b)R_(2c), CR₂R_(2a)SO₂CR_(2b)R_(2c), SO₂NR₂CR_(2a)R_(2b), COCR₂R_(2a), CR₂R_(2a)CO, CONR₅CR_(2a)R_(2b), CR₂R_(2a)CR_(2b)R_(2c)S, CR₂R_(2a)CR_(2b)R₂CSO, CR₂R_(2a)CR_(2b)R_(2c)SO₂, provided that L is not a bond when W is phenyl; R₂, R_(2a), R_(2b) and R_(2c) are independently hydrogen, halogen, alkyl or haloalkyl; or alternatively any two R₂, R_(2a), R_(2b), and R_(2c) can be taken together to which the atom they are attached to form a cycloalkyl, halogen substituted cycloalkyl or heterocyclyl ring; Z is selected from the following bicyclic heteroaryl groups:

R₃, R_(3a) and R_(3b) are independently hydrogen, halogen, —OH, —CN, —NO₂, —CO₂R_(2a), —CONR₂R_(2a), —SO₂NR₂R_(2a), —SOR_(2a), —SO₂R_(2a), —NR₂SO₂R₆, —NR₂CO₂F₆, alkyl, haloalkyl, cycloalkyl, alkoxy, aryloxy, alkenyl, haloalkoxy, alkylthio, arylthio, arylsulfonyl, alkylamino, aminoalkyl, arylamino, heteroarylanino, aryl, heteroyl or heterocyclyl, wherein the aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); R₄ is bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, both of which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R, —CO₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is cycloalkyl, other than bicyclo[2,2,2]octyl or bicyclo[2,2,1]heptyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is heterocyclyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); or R₄ is alkyl, which may be optionally substituted with one or more substituents selected from halogen, —OH, —OR₆, —SR₆, —OCOR₆, —CN, —NR₅COR₆, —NR₅SO₂R₆, —COR₆, —CO₂R₆, —CO₂H, —OCONR₂R_(2a), —CONR₂R_(2a), —NR₅CO₂R₆, —SO₂R₆, alkyl, alkoxy, aryl, amino, heterocyclyl or heteroaryl, wherein the alkyl, alkoxy, aryl, heteroaryl or heterocyclyl may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); R_(4a) is hydrogen, CN, alkyl, haloalkyl, aryl, substituted aryl, heteroaryl or substituted heteroaryl; R₅, at each occurrence, is independently hydrogen, alkyl, cycloalkyl, aryl, haloalkyl, COR_(2a), CO₂R_(2a), SO₂NR₂R_(2a), or SO₂R_(2a); R₆, at each occurrence, is independently alkyl, cycloalkyl, aryl or heteroaryl, all of which may be optionally substituted with with R₇, R_(7a), R_(7b), and R_(7c); and R₇, R_(7a), R_(7b), and R_(7c), at each occurrence, are independently halo, alkyl, haloalkyl, alkoxy, aryl, aryloxy, arylaryl, arylalkyl, arylalkyloxy, alkenyl, cycloalkyl, cycloalkylalkyl, cycloalkylalkyloxy, amino, —OH, hydroxyalkyl, acyl, heteroaryl, heteroaryloxy, heteroarylalkyl, heteroarylalkoxy, aryloxyalkyl, alkylthio, arylalkylthio, aryloxyaryl, alkylamido, alkanoylamino, arylcarbonylamino, —NO₂, —CN or thiol. 